NPIMap

Organization Active NPI

Specialized Diagnostics LLC

  • Neurology Physician
  • Metairie, LA
National Provider Identifier
1417023748
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
SPECIALIZED DIAGNOSTICS LLC
Practice address
3349 Ridgelake Dr
Suite 104
Metairie, LA 70002-3851
Phone
(504) 427-2829
Fax
(504) 347-2328
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mary N Boros
Title
Owner
Phone
(504) 427-2829

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

3349 Ridgelake Dr
Suite 104
Metairie, LA 70002-3851

Mailing address

3349 Ridgelake Dr
Suite 104
Metairie, LA 70002-3851
Phone (504) 427-2829

National Provider Directory

National Provider Directory

Locations

3349 Ridgelake Dr
Ste 104
Metairie, LA 70002
Phone (504) 427-2829

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417023748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3349 RIDGELAKE DR",
            "address_2": "SUITE 104",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700023851",
            "telephone_number": "504-427-2829",
            "fax_number": "504-347-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3349 RIDGELAKE DR",
            "address_2": "SUITE 104",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700023851",
            "telephone_number": "504-427-2829",
            "fax_number": "504-347-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOROS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-427-2829"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.