Provider Demographics
NPI:1982031472
Name:GENTILLY ACCIDENT AND INJURY CENTER
Entity Type:Organization
Organization Name:GENTILLY ACCIDENT AND INJURY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC ASST
Authorized Official - Prefix:MISS
Authorized Official - First Name:KAYE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PORET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-286-7808
Mailing Address - Street 1:4035 TOURO ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-3140
Mailing Address - Country:US
Mailing Address - Phone:504-286-7808
Mailing Address - Fax:504-286-1136
Practice Address - Street 1:4035 TOURO ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-3140
Practice Address - Country:US
Practice Address - Phone:504-286-7808
Practice Address - Fax:504-286-1136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty