1942453865 NPI number — JOSEPH SAMPOGNARO III

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942453865 NPI number — JOSEPH SAMPOGNARO III

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOSEPH SAMPOGNARO III
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1942453865
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3800 HOUMA BLVD
Provider Second Line Business Mailing Address:
SUITE 230
Provider Business Mailing Address City Name:
METAIRIE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70006-4182
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-889-9877
Provider Business Mailing Address Fax Number:
504-889-9880

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3800 HOUMA BLVD
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
METAIRIE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70006-4182
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-889-9877
Provider Business Practice Location Address Fax Number:
504-889-9880
Provider Enumeration Date:
10/23/2008

Additional Information

Authorized Official

Authorized Official Last Name:
SAMPOGNARO
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
504-889-9877

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  013270 , 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)





Copyright © 2007-2024 www.npivalidator.com