| |
3943 St. Bernard Avenue New Orleans LA 70122 | |
(504) 529-5558 | |
(504) 592-3989 |
Full Name | |
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Speciality | Clinic/Center |
Location | 3943 St. Bernard Avenue, New Orleans, Louisiana |
Authorized Official Name and Position | Mary H Deynoodt (COO) |
Authorized Official Contact | 5045295558 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1936 Magazine St New Orleans LA 70130-5016 Ph: (504) 529-5558 | 3943 St. Bernard Avenue New Orleans LA 70122 Ph: (504) 529-5558 |
NPI Number | 1699115600 |
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Provider Enumeration Date | 07/05/2013 |
Last Update Date | 11/17/2022 |
Medicare PECOS PAC ID | 8527163211 |
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Medicare Enrollment ID | O20131121001412 |
Identifier | Type | State | Issuer |
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1699115600 | NPI | - | NPPES |
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