Provider Demographics
NPI:1871763987
Name:LEWIS, VERONICA GARIBALDI (MD)
Entity type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:GARIBALDI
Last Name:LEWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:VERONICA
Other - Middle Name:AGNES
Other - Last Name:GARIBALDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6600 FRANKLIN AVE STE A2
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-5716
Mailing Address - Country:US
Mailing Address - Phone:504-226-5739
Mailing Address - Fax:504-322-2695
Practice Address - Street 1:6600 FRANKLIN AVE STE A2
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-5716
Practice Address - Country:US
Practice Address - Phone:504-226-5739
Practice Address - Fax:504-322-2695
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA68583208000000X
LA203111208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003129395AMedicaid
LA1508268Medicaid
LA203111OtherSTATE LICENSE
GA68583OtherSTATE LICENSE
GA68583OtherSTATE LICENSE