Provider Demographics
NPI:1912009408
Name:BISSANT, SANDY L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SANDY
Middle Name:L
Last Name:BISSANT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7221 ARBOR DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-3022
Mailing Address - Country:US
Mailing Address - Phone:504-242-2828
Mailing Address - Fax:
Practice Address - Street 1:3300 PARIS RD
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-2259
Practice Address - Country:US
Practice Address - Phone:504-271-4665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16230183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA0556050204Medicare ID - Type Unspecified