Provider Demographics
NPI:1326614587
Name:SAKETKOO MD, LLC
Entity Type:Organization
Organization Name:SAKETKOO MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN, SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SAKETKOO
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:504-237-5720
Mailing Address - Street 1:2622 CAMP ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-5619
Mailing Address - Country:US
Mailing Address - Phone:504-237-5720
Mailing Address - Fax:
Practice Address - Street 1:3525 PRYTANIA ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3500
Practice Address - Country:US
Practice Address - Phone:504-822-6653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-28
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1144253931OtherNPI TYPE I
LA1052043Medicaid