Provider Demographics
NPI:1821075763
Name:HEMATOLOGY ONCOLOGY CLINIC LLP
Entity Type:Organization
Organization Name:HEMATOLOGY ONCOLOGY CLINIC LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:MILETELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:225-767-0822
Mailing Address - Street 1:8595 PICARDY AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809
Mailing Address - Country:US
Mailing Address - Phone:225-767-0822
Mailing Address - Fax:225-767-9477
Practice Address - Street 1:8595 PICARDY AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809
Practice Address - Country:US
Practice Address - Phone:225-767-0822
Practice Address - Fax:225-767-9477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-30
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA0278430001Medicare NSC
57566Medicare PIN