Provider Demographics
NPI:1073578787
Name:BREAST DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:BREAST DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:504-342-4708
Mailing Address - Street 1:1340 POYDRAS ST
Mailing Address - Street 2:SUITE 1850
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-1221
Mailing Address - Country:US
Mailing Address - Phone:504-342-4708
Mailing Address - Fax:504-679-9928
Practice Address - Street 1:4204 HOUMA BLVD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2903
Practice Address - Country:US
Practice Address - Phone:504-883-8995
Practice Address - Fax:504-883-8996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CK73Medicare ID - Type UnspecifiedGROUP MEDICARE #