Individual
NICHOLAS JOSEPH DISALVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2700 NAPOLEON AVE, NEW ORLEANS, LA 70115-6914
(504) 842-4960
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD.207310
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07220551
—
LA
05
—
2149202
—
LA
Enumeration date
04/07/2011
Last updated
12/15/2014
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