Provider Demographics
NPI:1154765915
Name:CONNOR, ELLEN ELIZABETH (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:ELIZABETH
Last Name:CONNOR
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 HARING RD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-3110
Mailing Address - Country:US
Mailing Address - Phone:504-210-9960
Mailing Address - Fax:
Practice Address - Street 1:1300 HARING RD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-3110
Practice Address - Country:US
Practice Address - Phone:504-210-9960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2328573Medicaid