Provider Demographics
NPI:1700477221
Name:MILANO, BLAIR ANTHONY
Entity Type:Individual
Prefix:
First Name:BLAIR
Middle Name:ANTHONY
Last Name:MILANO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 N BENGAL RD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-5316
Mailing Address - Country:US
Mailing Address - Phone:504-352-5757
Mailing Address - Fax:
Practice Address - Street 1:3544 W ESPLANADE AVE S
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-7130
Practice Address - Country:US
Practice Address - Phone:504-889-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA011340183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist