Provider Demographics
NPI:1588428759
Name:D'ANTONI, EVAN (PA-C)
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:
Last Name:D'ANTONI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:EVAN
Other - Middle Name:
Other - Last Name:DANTONI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:301 CITY PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-4321
Mailing Address - Country:US
Mailing Address - Phone:504-256-9499
Mailing Address - Fax:
Practice Address - Street 1:180 W ESPLANADE AVE
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-2467
Practice Address - Country:US
Practice Address - Phone:504-256-9499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant