Provider Demographics
NPI:1932189974
Name:ANSEMAN, NORMAN EUGENE JR (MD)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:EUGENE
Last Name:ANSEMAN
Suffix:JR
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 1:3440 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-8606
Mailing Address - Country:US
Mailing Address - Phone:337-237-3637
Mailing Address - Fax:504-837-5245
Practice Address - Street 1:3440 DIVISION ST STE I
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-8607
Practice Address - Country:US
Practice Address - Phone:048-375-2445
Practice Address - Fax:504-837-5245
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA012249208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1197939Medicaid
LA436625360OtherBLUE CROSS BLUE SHIELD OF
LA110008256OtherRAILROAD MEDICARE
LA70503001OtherCHAMPUS
LA70503001OtherCHAMPUS
LA436625360OtherBLUE CROSS BLUE SHIELD OF
LAB62335Medicare UPIN