Provider Demographics
NPI:1720868649
Name:DIVYA, AABHA (MBBS, MS, MCH)
Entity type:Individual
Prefix:DR
First Name:AABHA
Middle Name:
Last Name:DIVYA
Suffix:
Gender:
Credentials:MBBS, MS, MCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 TULANE AVE # 8622
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2632
Mailing Address - Country:US
Mailing Address - Phone:504-988-2307
Mailing Address - Fax:
Practice Address - Street 1:4228 HOUMA BLVD STE 510
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-3015
Practice Address - Country:US
Practice Address - Phone:504-988-6113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3013688390200000X
LA344382208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program