Provider Demographics
NPI:1104830249
Name:PANIELLO, SANTO J (MD)
Entity Type:Individual
Prefix:DR
First Name:SANTO
Middle Name:J
Last Name:PANIELLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2429
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:
Practice Address - Street 1:1850 GAUSE BLVD E
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-5442
Practice Address - Country:US
Practice Address - Phone:985-639-3777
Practice Address - Fax:985-661-3512
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70820207V00000X
LA327575207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006799200Medicaid
FLP01150972OtherR&R MEDICARE
FL31345XMedicare PIN