Provider Demographics
NPI:1114067279
Name:EYE LASER INSTITUTE
Entity Type:Organization
Organization Name:EYE LASER INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:CERISE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-883-7668
Mailing Address - Street 1:4324 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-5445
Mailing Address - Country:US
Mailing Address - Phone:504-883-7668
Mailing Address - Fax:504-883-7693
Practice Address - Street 1:4324 VETERANS MEMORIAL BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-5445
Practice Address - Country:US
Practice Address - Phone:504-883-7668
Practice Address - Fax:504-883-7693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery