Basic Information
Provider Information
NPI: 1891271698
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ESPINOSA
FirstName: PAOLA
MiddleName: VALERIA
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4710 S CARROLLTON AVE
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701196027
CountryCode: US
TelephoneNumber: 5044549020
FaxNumber: 5044549031
Practice Location
Address1: 4710 S CARROLLTON AVE
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701196027
CountryCode: US
TelephoneNumber: 5044549020
FaxNumber: 5044549031
Other Information
ProviderEnumerationDate: 07/14/2018
LastUpdateDate: 08/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X332732LAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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