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THE DERMATOLOGY CLINIC OF ST TAMMANY II LLC NPI 1356421010


NPI Information

NPI: 1356421010
Provider Name: THE DERMATOLOGY CLINIC OF ST TAMMANY II, LLC

Doing Business As: GRIESHABER DERMATOLOGY

Classification: Dermatology - 207NS0135X
Entity Type: Organization

Specialization: Procedural Dermatology

Address:
714 W 16TH AVE
COVINGTON, LA
ZIP 70433
Phone: (985) 893-1035
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THE DERMATOLOGY CLINIC OF ST TAMMANY II, LLC is a procedural dermatology dermatology in Covington, LA. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). THE DERMATOLOGY CLINIC OF ST TAMMANY II, LLC NPI is 1356421010. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Grieshaber Dermatology.

The provider's business location address is:

714 W 16TH AVE
COVINGTON, LA
ZIP 70433-422
Phone: (985) 893-1035
Fax: (985) 893-1058

The provider's authorized official is Emily Katherine Grieshaber .
The authorized official title is Manager and has the following contact phone number (985) 893-1035.

The enumeration date for this NPI number is 10/17/2006 and was last updated on 12/5/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207NS0135XDermatologyProcedural Dermatology08440 52 06LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11054810MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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