Provider Demographics
NPI:1013025048
Name:LUIS A GIUFFRA LLC
Entity Type:Organization
Organization Name:LUIS A GIUFFRA LLC
Other - Org Name:LUIS A GIUFFRA LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:GIUFFRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-251-7720
Mailing Address - Street 1:621 S NEW BALLAS RD
Mailing Address - Street 2:SUITE 398A
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8232
Mailing Address - Country:US
Mailing Address - Phone:314-251-7720
Mailing Address - Fax:314-251-7722
Practice Address - Street 1:621 S NEW BALLAS RD
Practice Address - Street 2:SUITE 398A
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8232
Practice Address - Country:US
Practice Address - Phone:314-251-7720
Practice Address - Fax:314-251-7722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209768217Medicaid
MO000094875Medicare ID - Type Unspecified
MOF84854Medicare UPIN