Provider Demographics
NPI:1619071347
Name:NEW ORLEANS UROLOGIC INSTITUTE, L.L.C
Entity Type:Organization
Organization Name:NEW ORLEANS UROLOGIC INSTITUTE, L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHEE-AWAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-371-0071
Mailing Address - Street 1:1111 MEDICAL CENTER BLVD
Mailing Address - Street 2:SUITE313N
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072
Mailing Address - Country:US
Mailing Address - Phone:504-371-0071
Mailing Address - Fax:507-371-0272
Practice Address - Street 1:1111 MEDICAL CENTER BLVD
Practice Address - Street 2:SUITE313N
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072
Practice Address - Country:US
Practice Address - Phone:504-371-0071
Practice Address - Fax:507-371-0272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1448826Medicaid
LADF2612OtherMEDICARE RAIL ROAD
692839OtherAETNA
LA1448826Medicaid