SPECIALIZED DIAGNOSTICS LLC (NPI# 1417023748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417023748 |
| Entity Type | Organization |
| Organization Name | SPECIALIZED DIAGNOSTICS LLC |
| Practice Address |
3349 Ridgelake Dr Suite 104 Metairie LA 70002-3851 |
| Practice Telephone | 5044272829 |
| Practice Fax Number | 5043472328 |
| Mailing Telephone | 5044272829 |
| Mailing Fax Number | 5043472328 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARY N BOROS (OWNER) |
| Authorized Official Telephone | 5044272829 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
| Street Address |
3349 RIDGELAKE DR SUITE 104 |
| City | METAIRIE |
| State | LA |
| Zip Code | 70002-3851 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912445206 | Hope and Healing Support Services | Community/Behavioral Health | 3349 Ridgelake Dr, Suite 204, Metairie, LA 70002-3851 | 2017-02-07 |
| 1063785996 | Advantage Suboxone Clinic, Inc | Clinic/Center | 3349 Ridgelake Dr, Metairie, LA 70002-3851 | 2012-02-23 |
| 1558530170 | Thomas A Fonseca | Counselor | 3349 Ridgelake Dr, Suite 204, Metairie, LA 70002-3851 | 2008-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114541737 | Solstice Technologies, Inc. | Clinical Medical Laboratory | 3501 Severn Ave Suite 24, Metairie, LA 70002 | 2020-05-29 |
| 1891335071 | Kristin Alongi | Nurse Practitioner | 3838 N Causeway Blvd. Ste 2200, Metairie, LA 70002 | 2020-01-15 |
| 1841850450 | Emily Suarez Tan | Dentist | 3301 Veterans Blvd., Suite 203, Metairie, LA 70002 | 2019-06-17 |
| 1902369317 | Unitedhealthcare of Louisiana, Inc. | Health Maintenance Organization | 3838 N. Causeway Blvd., Suite 2600, Metairie, LA 70002 | 2019-04-11 |
| 1013479195 | Jeffrey Scott Toler | Dentist | 2937 Veterans Memorial Blvd, Ste C, Metairie, LA 70002 | 2019-04-05 |
| 1982188470 | Kelly Brooke Anderson | Clinic/Center | 2215 Veterans Blvd, Metairie, LA 70002 | 2018-09-20 |
| 1831695253 | A&g Pediatrics LLC | Community Based Residential Treatment Facility, Mental Illness | 3001 Division St., Suite 206, Metairie, LA 70002 | 2018-04-04 |
| 1730691064 | Desire Care, LLC | Technician | 2800 Hessmer Ave, Suite B, Metairie, LA 70002 | 2017-10-26 |
| 1104338458 | Monet Wiltz | Case Manager/Care Coordinator | 2637 Edenborn Ave Ste 302, Metairie, LA 70002 | 2017-10-26 |
| 1316461395 | Crystal Mc Bride | Counselor | 3100 Ridgelake Dr. Suite 309, Metairie, LA 70002 | 2017-08-01 |
| Find all providers in zip 70002 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316105182 | Troy Allan Beaucoudray | Psychiatry & Neurology | 3409 Division St, Metairie, LA 70002-4611 | 2008-05-29 |
| 1922293372 | East Jefferson Physicians Group LLC | Psychiatry & Neurology | 4300 Houma Blvd., Ste. 202, Metairie, LA 70006-2924 | 2007-09-10 |
| 1750347878 | John Kevin Jackson | Psychiatry & Neurology | 2905 Kingman St, Metairie, LA 70006-6615 | 2006-04-26 |
| 1902804933 | Debra L Burris | Psychiatry & Neurology | 110 Veterans Memorial Blvd, Suite 105, Metairie, LA 70005-3027 | 2005-07-13 |
| 1215935275 | Michael T Happel | Psychiatry & Neurology | 110 Veterans Memorial Blvd Ste 325, Metairie, LA 70005-4961 | 2005-07-13 |
| 1891069118 | Daniel J Trahant, Md (apmc) | Psychiatry & Neurology | 3901 Houma Blvd, Suite 305, Metairie, LA 70006-2930 | 2012-03-05 |
| 1780974774 | Frank Jefferson Williams Jr. | Psychiatry & Neurology | 3800 Houma Blvd, Ste 205, Metairie, LA 70006-4151 | 2011-04-12 |
| 1639330996 | Brian Wade Peterson | Psychiatry & Neurology | 3800 Houma Blvd, Suite 205, Metairie, LA 70006-4182 | 2008-06-19 |
| 1003088915 | Amy Wilcox Voigt | Psychiatry & Neurology | 2905 Kingman St, Metairie, LA 70006-6615 | 2008-03-31 |
| 1508036195 | Enrique Segura | Psychiatry & Neurology | 3800 Houma Blvd, Ste 205, Metairie, LA 70006-4151 | 2008-03-10 |
| Find all providers in METAIRIE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.