Provider Demographics
NPI:1437488871
Name:BIANCHINI-PELLEGRIN
Entity Type:Organization
Organization Name:BIANCHINI-PELLEGRIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:PELLEGRIN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PNP
Authorized Official - Phone:504-780-1702
Mailing Address - Street 1:3939 HOUMA BLVD
Mailing Address - Street 2:STE 223
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2931
Mailing Address - Country:US
Mailing Address - Phone:504-780-1702
Mailing Address - Fax:504-780-1705
Practice Address - Street 1:8120 MAIN ST
Practice Address - Street 2:STE 405
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-3403
Practice Address - Country:US
Practice Address - Phone:985-868-2756
Practice Address - Fax:985-868-8986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty