Individual
DANIELA IACONA-CARBONELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4433
(504) 842-9725
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4433
(504) 842-9725
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
303788
LA
363AM0700X
Medical Physician Assistant
007026
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00632777
—
MS
05
—
02055672
—
NY
05
—
2438255
—
LA
Enumeration date
12/14/2005
Last updated
07/06/2017
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