1366527756 NPI number — DR. NANO K ZERINGUE M.D.

Table of content: DR. NANO K ZERINGUE M.D. (NPI 1366527756)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366527756 NPI number — DR. NANO K ZERINGUE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZERINGUE
Provider First Name:
NANO
Provider Middle Name:
K
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366527756
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
900 CANAL BLVD STE 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
THIBODAUX
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70301-4506
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-448-3353
Provider Business Mailing Address Fax Number:
985-448-1276

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 CANAL BLVD STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
THIBODAUX
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70301-4506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-448-3353
Provider Business Practice Location Address Fax Number:
985-448-1276
Provider Enumeration Date:
10/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  12816R , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: 12816R , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00155035 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 0007025369 . This is a "AETNA" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 1574155 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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