Healthcare Provider Details

I. General information

NPI: 1801154729
Provider Name (Legal Business Name): ANASTASIA A BARTHELEMY BROWN AAS, BBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2012
Last Update Date: 07/22/2021
Certification Date: 07/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 MANHATTAN BLVD BLDG D SUITE 121
HARVEY LA
70058
US

IV. Provider business mailing address

1901 MANHATTAN BLVD BLDG D SUITE 121
HARVEY LA
70058
US

V. Phone/Fax

Practice location:
  • Phone: 504-372-6326
  • Fax: 504-336-3160
Mailing address:
  • Phone: 504-372-6326
  • Fax: 504-336-3160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberLDO002099
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMEXXXXXXX
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberLA17XXX
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code156FC0800X
TaxonomyContact Lens Technician/Technologist
License Number151353
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code156FC0801X
TaxonomyContact Lens Fitter
License NumberLDO002099
License Number StateGA
# 6
Primary TaxonomyN
Taxonomy Code156FX1101X
TaxonomyOphthalmic Assistant
License Number151353
License Number StateLA
# 7
Primary TaxonomyN
Taxonomy Code156FX1202X
TaxonomyOptometric Technician
License Number
License Number StateLA
# 8
Primary TaxonomyN
Taxonomy Code156FX1202X
TaxonomyOptometric Technician
License Number151353
License Number StateLA
# 9
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberD8A3EXXX
License Number StateLA
# 10
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 11
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1XX-XXXXXX
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: