Healthcare Provider Details

I. General information

NPI: 1548164403
Provider Name (Legal Business Name): CITI CUSTOMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3734 GIBSON ST
NEW ORLEANS LA
70122-1504
US

IV. Provider business mailing address

3734 GIBSON ST
NEW ORLEANS LA
70122-1504
US

V. Phone/Fax

Practice location:
  • Phone: 504-413-5130
  • Fax:
Mailing address:
  • Phone: 504-413-5130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number StateNULL

VIII. Authorized Official

Name: EMANUEL AUGUSTA
Title or Position: CEO
Credential:
Phone: 504-413-5130