Provider Demographics
NPI:1144539214
Name:NEW ORLEANS MUSICIANS ASSISTANCE FOUNDATION
Entity type:Organization
Organization Name:NEW ORLEANS MUSICIANS ASSISTANCE FOUNDATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ELLIS
Authorized Official - Middle Name:JOHANN
Authorized Official - Last Name:BULTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-388-4396
Mailing Address - Street 1:1525 LOUISIANA AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3507
Mailing Address - Country:US
Mailing Address - Phone:504-895-4396
Mailing Address - Fax:504-895-4396
Practice Address - Street 1:2820 NAPOLEON AVE
Practice Address - Street 2:SUITE 890
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-6969
Practice Address - Country:US
Practice Address - Phone:504-412-1366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-06
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty