Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 022569 | LA |
N | 207RH0003X | Hematology & Oncology | 17437 | MS |
NPI | 1043375363 |
---|---|
Provider Name | Allen R. Calabresi |
First Address | Slidell, LA 70458-2069 |
Second Address | Slidell, LA 70458 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 22/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04659300 | (05) | MS |
1483401 | (05) | LA |
H37765 | (02) | LA |
H37765 | (02) | MS |