Peterson, Diana Moustoukas
Peterson, Diana Moustoukas is an sole proprietor health care provider with primary practice located at 1315 Jefferson Hwy , New Orleans LA 70121-2406. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Peterson, Diana Moustoukas can be contacted via phone (504) 842-3900.Contact Information
Primary practice address
1315 Jefferson Hwy
New Orleans LA 70121-2406
Phone: (504) 842-3900
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD.205215 | Louisiana |
Profile Details
| NPI number | 1780845503 |
|---|---|
| LBN Legal business name | Peterson, Diana Moustoukas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 24th, 2008 |
| Last updated | Jul 8th, 2014 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780845503 | NPPES |
| Louisiana | MEDICAID | 2302451 | |
| Louisiana | MEDICAID | 00923576 |
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