Healthcare Provider Details

I. General information

NPI: 1952524522
Provider Name (Legal Business Name): ZICHICHI PODIATRY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 HOUMA BLVD SUITE 204
METAIRIE LA
70006-2930
US

IV. Provider business mailing address

3901 HOUMA BLVD SUITE 204
METAIRIE LA
70006-2930
US

V. Phone/Fax

Practice location:
  • Phone: 504-888-9403
  • Fax: 504-888-2895
Mailing address:
  • Phone: 504-888-9403
  • Fax: 504-888-2895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPD066R
License Number StateLA

VIII. Authorized Official

Name: MR. STEVEN JOSEPH ZICHICHI
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 504-888-9403