Licciardi, Dolleen

Licciardi, Dolleen is an individual health care provider with primary practice located at 141 Ormond Center Ct , Destrehan LA 70047-2548. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Licciardi, Dolleen can be contacted via phone (985) 764-7337.

Contact Information

Primary practice address
141 Ormond Center Ct Destrehan LA 70047-2548
Fax: (985) 764-5333
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 17300 Louisiana

Profile Details

NPI number 1629072558
LBN Legal business name Licciardi, Dolleen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Jan 7th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629072558 NPPES
Louisiana MEDICAID 1364045

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