Provider Demographics
NPI:1972709822
Name:CUCINOTTA & OCCHIPINTI MDS APC
Entity Type:Organization
Organization Name:CUCINOTTA & OCCHIPINTI MDS APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:JACQUES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-454-3277
Mailing Address - Street 1:4770 S I 10 SERVICE RD W STE 110
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-1224
Mailing Address - Country:US
Mailing Address - Phone:504-454-3277
Mailing Address - Fax:504-887-8934
Practice Address - Street 1:4770 S I 10 SERVICE RD W STE 110
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001
Practice Address - Country:US
Practice Address - Phone:504-454-3277
Practice Address - Fax:504-887-8934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2173448Medicaid
LA2173448Medicaid