Provider Demographics
NPI:1699740563
Name:EAST JEFFERSON INTERVENTIONAL PAIN CENTER
Entity type:Organization
Organization Name:EAST JEFFERSON INTERVENTIONAL PAIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAPANZANNO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-779-5558
Mailing Address - Street 1:PO BOX 54008
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70505-4008
Mailing Address - Country:US
Mailing Address - Phone:504-779-5558
Mailing Address - Fax:
Practice Address - Street 1:4500 CLEARVIEW PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2371
Practice Address - Country:US
Practice Address - Phone:504-779-5558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-22
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty