Provider Demographics
NPI:1104879659
Name:POTASH, MORDECAI (MD)
Entity type:Individual
Prefix:DR
First Name:MORDECAI
Middle Name:
Last Name:POTASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 CANAL ST
Mailing Address - Street 2:TULANE PSYCHIATRY DEPARTMENT, 10TH FLOOR, TB-48
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2703
Mailing Address - Country:US
Mailing Address - Phone:504-988-5405
Mailing Address - Fax:
Practice Address - Street 1:1440 CANAL ST
Practice Address - Street 2:TULANE PSYCHIATRY DEPARTMENT, 10TH FLOOR, TB-48
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2703
Practice Address - Country:US
Practice Address - Phone:504-988-5405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
LAMD.0240302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist