Provider Demographics
NPI:1316638489
Name:VEIN SPECIALIST MOBILE LAB
Entity type:Organization
Organization Name:VEIN SPECIALIST MOBILE LAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-515-6837
Mailing Address - Street 1:2651 POYDRAS ST APT 3404
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-7591
Mailing Address - Country:US
Mailing Address - Phone:504-515-5735
Mailing Address - Fax:
Practice Address - Street 1:2651 POYDRAS ST APT 3404
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7591
Practice Address - Country:US
Practice Address - Phone:504-515-5735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty