Provider Demographics
NPI:1154374437
Name:PINKOZIE, DENNIS (CRNA)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:PINKOZIE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BERKLEY AVE
Mailing Address - Street 2:
Mailing Address - City:HARAHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70123-4601
Mailing Address - Country:US
Mailing Address - Phone:504-737-3120
Mailing Address - Fax:
Practice Address - Street 1:1415 TULANE AVE
Practice Address - Street 2:HC 71
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2600
Practice Address - Country:US
Practice Address - Phone:504-988-5881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH129053367500000X
LAAP04830367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06770589Medicaid
LA1009822Medicaid
LAP00413430OtherRR MEDICARE
OH0640579Medicaid
LAP00413430OtherRR MEDICARE