Provider Demographics
NPI:1306978119
Name:DOLAN, CELESTE JUSTINA (MSPT, MD)
Entity type:Individual
Prefix:DR
First Name:CELESTE
Middle Name:JUSTINA
Last Name:DOLAN
Suffix:
Gender:F
Credentials:MSPT, MD
Other - Prefix:
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Mailing Address - Street 1:1430 TULANE AVE
Mailing Address - Street 2:SL-50
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2632
Mailing Address - Country:US
Mailing Address - Phone:504-988-7809
Mailing Address - Fax:504-988-3971
Practice Address - Street 1:1430 TULANE AVE
Practice Address - Street 2:SL-50
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2632
Practice Address - Country:US
Practice Address - Phone:504-988-7809
Practice Address - Fax:504-988-3971
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR.00638792084A2900X, 2084N0400X
CAPT 33313225100000X
LAPT 07500R225100000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAPT 07500ROtherLA BOARD OF PT
CAPT 33313OtherCA BOARD OF PT