1407055023 NPI number — BIANCHINI-WOLFSON LLC

Table of content: (NPI 1407055023)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407055023 NPI number — BIANCHINI-WOLFSON LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BIANCHINI-WOLFSON 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:
1407055023
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3939 HOUMA BLVD
Provider Second Line Business Mailing Address:
SUITE #223
Provider Business Mailing Address City Name:
METAIRIE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70006-2931
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:
3939 HOUMA BLVD
Provider Second Line Business Practice Location Address:
SUITE #223
Provider Business Practice Location Address City Name:
METAIRIE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70006-2931
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-780-1702
Provider Business Practice Location Address Fax Number:
504-780-1705
Provider Enumeration Date:
07/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WOLFSON
Authorized Official First Name:
AARON
Authorized Official Middle Name:
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
504-780-1702

Provider Taxonomy Codes

  • Taxonomy code: 103TB0200X , with the licence number:  863 , 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: $$$$$$$$$ . This is a "SOCIAL SECURITY NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 863 . This is a "STATE LICENSE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com