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General NPI Number Information
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NPI Number | 1073578787
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Entity Type | Organization
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Legal Business Name | BREAST DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4204 HOUMA BLVD
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City | METAIRIE
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State | LA
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Zip | 70006-2903
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Country | US
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Telephone | 504-883-8995
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Fax | 504-883-8996
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Provider Business Mailing Address
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Address Line | 1340 POYDRAS ST SUITE 1850
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City | NEW ORLEANS
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State | LA
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Zip | 70112-1221
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Country | US
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Telephone | 504-342-4708
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Fax | 504-679-9928
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Authorized Official
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Title or Position | DIRECTOR
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Name | WILLIAM STEIN III
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Credential | MD
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Telephone | 504-342-4708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number |
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License Number State |
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