| Bianchini-holcomb | |
|
4050 Lonesome Rd Ste A Mandeville LA 70448-7085 | |
| (985) 246-2600 | |
| (985) 246-6100 |
| Full Name | Bianchini-holcomb |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 4050 Lonesome Rd Ste A, Mandeville, Louisiana |
| Authorized Official Name and Position | Kevin Bianchini (MANAGER MEMBER) |
| Authorized Official Contact | 5047801702 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bianchini-holcomb 2901 N I 10 Service Rd E Ste 300 Metairie LA 70002-6137 Ph: (504) 780-1702 | Bianchini-holcomb 4050 Lonesome Rd Ste A Mandeville LA 70448-7085 Ph: (985) 246-2600 |
| NPI Number | 1700276490 |
|---|---|
| Provider Enumeration Date | 02/02/2015 |
| Last Update Date | 10/25/2016 |
| Medicare PECOS PAC ID | 4880996925 |
|---|---|
| Medicare Enrollment ID | O20161214000376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700276490 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 1310 (Louisiana) | Primary |
| Provider Name | Matthew J Holcomb |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831500511 PECOS PAC ID: 9830491976 Enrollment ID: I20161214002253 |
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