Provider Demographics
NPI:1902434509
Name:BROUSSARD, ALAINA LOFASO (MD)
Entity Type:Individual
Prefix:
First Name:ALAINA
Middle Name:LOFASO
Last Name:BROUSSARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALAINA
Other - Middle Name:CLAIRE
Other - Last Name:LOFASO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2924 CLAYCUT RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-6801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1514 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121-2429
Practice Address - Country:US
Practice Address - Phone:504-842-3925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program