Provider Demographics
NPI:1144573098
Name:JERYL REISER-PARMENTER DO LLC
Entity Type:Organization
Organization Name:JERYL REISER-PARMENTER DO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JERYL
Authorized Official - Middle Name:L
Authorized Official - Last Name:REISER-PARMENTER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:504-609-3500
Mailing Address - Street 1:1320 PRENTISS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122
Mailing Address - Country:US
Mailing Address - Phone:504-609-3500
Mailing Address - Fax:
Practice Address - Street 1:1320 PRENTISS AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122
Practice Address - Country:US
Practice Address - Phone:504-609-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-16
Last Update Date:2015-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LADO.000184207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty