Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | P-138 | LA |
Y | 1223G0001X | General Practice | DS024969L | PA |
Y | 213EG0000X | General Practice | DS024969L | PA |
NPI | 1003881905 |
---|---|
Provider Name | Dr. Nicholas John Miniotis |
First Address | New Orleans, LA 70119-2714 |
Second Address | New Orleans, LA 70119-2714 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2006 |
Last Update Date | 05/11/2012 |