Provider Demographics
NPI:1376616532
Name:DANNA, NICHOLAS ALOYSIUS III (MD)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:ALOYSIUS
Last Name:DANNA
Suffix:III
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 1:3116 6TH STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1713
Mailing Address - Country:US
Mailing Address - Phone:504-837-9000
Mailing Address - Fax:504-837-8293
Practice Address - Street 1:3116 6TH STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-1713
Practice Address - Country:US
Practice Address - Phone:504-837-9000
Practice Address - Fax:504-837-8293
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7262208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1940534Medicaid