Provider Demographics
NPI:1891917134
Name:CHECKUPS - LA LLC
Entity Type:Organization
Organization Name:CHECKUPS - LA LLC
Other - Org Name:CHECKUPS HOLDING, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:TAWIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-760-0050
Mailing Address - Street 1:1359 BROADWAY
Mailing Address - Street 2:SUITE 2001
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018
Mailing Address - Country:US
Mailing Address - Phone:212-760-0050
Mailing Address - Fax:
Practice Address - Street 1:2799 WEST THOMAS STREET
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-2838
Practice Address - Country:US
Practice Address - Phone:212-760-0050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty