1356714604 NPI number — BIANCHINI BRENNAN LEWIS

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 1356714604 NPI number — BIANCHINI BRENNAN LEWIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BIANCHINI BRENNAN LEWIS
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:
1356714604
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/09/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2901 N I 10 SERVICE RD E
Provider Second Line Business Mailing Address:
STE 300
Provider Business Mailing Address City Name:
METAIRIE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70002-6137
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-780-1702
Provider Business Mailing Address Fax Number:
504-780-1705

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
145 ROBERT E LEE BLVD
Provider Second Line Business Practice Location Address:
STE 300
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70124-2552
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-309-4924
Provider Business Practice Location Address Fax Number:
504-309-4928
Provider Enumeration Date:
11/09/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BIANCHINI
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
J
Authorized Official Title or Position:
MANAGER MEMBER
Authorized Official Telephone Number:
504-780-1702

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  1195 , 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)