Provider Demographics
NPI:1821090853
Name:LA NASA, JOSEPH ALOYSIUS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ALOYSIUS
Last Name:LA NASA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1430 TULANE AVE
Mailing Address - Street 2:SL-42
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2632
Mailing Address - Country:US
Mailing Address - Phone:504-988-5274
Mailing Address - Fax:504-988-5059
Practice Address - Street 1:4720 S I 10 SERVICE RD W
Practice Address - Street 2:SUITE 100
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-7404
Practice Address - Country:US
Practice Address - Phone:504-988-8100
Practice Address - Fax:504-988-8101
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA010968174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1130214Medicaid
LAB60794Medicare UPIN
LA4P757Medicare PIN
LA0821080001Medicare NSC