Organization
MICHAEL N KLEAMENAKIS
Active
Other names
Gentilly Vision Source
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KLEAMENAKIS O.D. (OWNER)
(504) 288-2333
Entity
Organization
Contact information
Practice address
4114 MARIGNY ST, NEW ORLEANS, LA 70122-4931
(504) 288-2333
(504) 288-2227
Mailing address
4114 MARIGNY ST, NEW ORLEANS, LA 70122-4931
(504) 288-2333
(504) 288-2227
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
1030-060T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1370142
—
LA
Enumeration date
03/04/2010
Last updated
12/12/2018
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