Provider Demographics
NPI:1982774550
Name:PICONE, JOANNA RICOTTA (PT)
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:RICOTTA
Last Name:PICONE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70051 4TH ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-8402
Mailing Address - Country:US
Mailing Address - Phone:504-616-6056
Mailing Address - Fax:
Practice Address - Street 1:340 FALCONER DRIVE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433
Practice Address - Country:US
Practice Address - Phone:985-893-2845
Practice Address - Fax:985-893-2654
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06381174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4H472Medicare ID - Type Unspecified