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General NPI Number Information
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NPI Number | 1124213228
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Entity Type | Organization
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Legal Business Name | FRIENDLY CARE DIAGNOSTIC SERVICES INC
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 04/01/2011
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Provider Practice Location Address
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Address Line | 3216 N TURNBULL DR SUITE B
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City | METAIRIE
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State | LA
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Zip | 70002-5732
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Country | US
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Telephone | 504-885-6932
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Fax | 504-885-2987
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Provider Business Mailing Address
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Address Line | 3216 N TURNBULL DR SUITE B
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City | METAIRIE
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State | LA
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Zip | 70002-5732
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Country | US
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Telephone | 504-885-6932
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Fax | 504-885-2987
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Authorized Official
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Title or Position | CEO
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Name | SERGO KUTELIA
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Credential |
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Telephone | 818-219-7003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State | LA
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