Carollo, Dominic Stephen
Carollo, Dominic Stephen is an individual health care provider with primary practice located at 1514 Jefferson Highway , New Orleans LA 70121-2429. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatric Anesthesiology. Allopathic & Osteopathic Physicians / Pediatric Anesthesiology is his primary health care specialty. Carollo, Dominic Stephen can be contacted via phone (504) 842-3755.Contact Information
Primary practice address
1514 Jefferson Highway
New Orleans LA 70121-2429
Phone: (504) 842-3755
Fax: (504) 842-3193
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Pediatric Anesthesiology | 207LP3000X | MD3201535 | Louisiana |
Profile Details
| NPI number | 1225228133 |
|---|---|
| LBN Legal business name | Carollo, Dominic Stephen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 26th, 2007 |
| Last updated | Oct 4th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225228133 | NPPES |
| Mississippi | MEDICAID | 03400891 | |
| Mississippi | MEDICAID | 1077224 |
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