Provider Demographics
NPI:1467980516
Name:MACALUSO, NATHAN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:MACALUSO
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 DUBLIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-1022
Mailing Address - Country:US
Mailing Address - Phone:504-861-4693
Mailing Address - Fax:504-865-8379
Practice Address - Street 1:714 DUBLIN ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-1022
Practice Address - Country:US
Practice Address - Phone:504-861-4693
Practice Address - Fax:504-865-8379
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09647225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist