1952525719 NPI number — ST TAMMANY CARDIOVASCULAR SPECIALISTS LLC

Table of content: (NPI 1952525719)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952525719 NPI number — ST TAMMANY CARDIOVASCULAR SPECIALISTS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST TAMMANY CARDIOVASCULAR SPECIALISTS LLC
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:
1952525719
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DEPT 165016
Provider Second Line Business Mailing Address:
P O BOX 62600
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70162-2600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-792-7325
Provider Business Mailing Address Fax Number:
985-792-7327

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4404 HIGHWAY 22
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANDEVILLE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70471-3310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-792-7325
Provider Business Practice Location Address Fax Number:
985-792-7327
Provider Enumeration Date:
04/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MALIK
Authorized Official First Name:
NAVEED
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
985-778-5754

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207UN0901X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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