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Organization

ALFEREZ, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MARY E MARTINEZ (CLINIC ADMINISTRATION)
(504) 417-3728
Entity
Organization

Contact information

Practice address
4700 WICHERS DR, SUITE 304, MARRERO, LA 70072-3054
(504) 644-4787
(504) 644-4790
Mailing address
4700 WICHERS DRIVE, SUITE 304, MARRERO, LA 70072-3054
(504) 644-4787
(504) 274-1332

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
16902
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1362077
LA
Enumeration date
02/23/2012
Last updated
02/23/2012
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