Provider Demographics
NPI:1922353150
Name:PENELOPE TREECE, APMC
Entity Type:Organization
Organization Name:PENELOPE TREECE, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PENELOPE
Authorized Official - Middle Name:
Authorized Official - Last Name:TREECE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-779-7749
Mailing Address - Street 1:PO BOX 113545
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70011-3545
Mailing Address - Country:US
Mailing Address - Phone:504-779-7749
Mailing Address - Fax:504-779-7763
Practice Address - Street 1:3815 HESSMER AVE
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3211
Practice Address - Country:US
Practice Address - Phone:504-779-7749
Practice Address - Fax:504-779-7763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA021535174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty