Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | P-166 | LA |
NPI | 1023478633 |
---|---|
Provider Name | Dr. Faye Mascarenhas |
First Address | New Orleans, LA 70119-2715 |
Second Address | New Orleans, LA 70119-2715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2016 |
Last Update Date | 25/02/2016 |