Provider Demographics
NPI:1972619757
Name:LEJEMTEL, THIERRY HUBERT (MD)
Entity type:Individual
Prefix:DR
First Name:THIERRY
Middle Name:HUBERT
Last Name:LEJEMTEL
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 1:1430 TULANE AVE
Mailing Address - Street 2:SL-48
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2632
Mailing Address - Country:US
Mailing Address - Phone:504-988-5152
Mailing Address - Fax:504-988-4237
Practice Address - Street 1:1415 TULANE AVE
Practice Address - Street 2:HC 48
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2600
Practice Address - Country:US
Practice Address - Phone:504-988-5152
Practice Address - Fax:504-988-4237
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA199961207RC0000X
LAMD.199961207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1473251Medicaid
LA4J551Medicare PIN
LA1473251Medicaid