Immunolase LLC

Primary specialty

Clinical & Laboratory Immunology (Allergy & Immunology) PhysicianTaxonomy code 207KI0005X

License

19D2105974 Issued in LA

Legal business name

IMMUNOLASE LLC

Practice address

1901 Manhattan Blvd BLDG D
Harvey, LA 70058-3583

Phone

(504) 372-6250

NPI assigned

Feb 9, 2016

Last updated

Mar 23, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brennen Lark

Title

Member/Ceo

Phone

(504) 372-6250

Specialties & licenses 1

Addresses

Other identifiers 12

Locations

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

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521763200000",
    "number": "1427416171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1414",
            "city": "SAGAMORE BEACH",
            "state": "MA",
            "postal_code": "025621414",
            "telephone_number": "504-372-6250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 MANHATTAN BLVD BLDG D",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700583583",
            "telephone_number": "504-372-6250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMUNOLASE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-09",
        "last_updated": "2018-03-23",
        "status": "A",
        "authorized_official_last_name": "LARK",
        "authorized_official_first_name": "BRENNEN",
        "authorized_official_title_or_position": "MEMBER/CEO",
        "authorized_official_telephone_number": "504-372-6250"
    },
    "taxonomies": [
        {
            "code": "207KI0005X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Clinical & Laboratory Immunology",
            "state": "LA",
            "license": "19D2105974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1427182989",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1891185948",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1386653251",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1811939606",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1316972656",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1437117751",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1255690483",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1306275615",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1952739575",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1215993084",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1497794259",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1851325823",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lana Duncan Huling, NURSE PRACTITIONER
• Antongio Humphery
• Alvin Hunt Jr., RSW, MSW
• Brian Hunter
• Hanan T Ibrahim
• Impact Behavior Health Services LLC.
• Impact Counseling & Support Services LLC
• Joseph M Imseis, MD
• Invision Optical, LLC
• Trinity Isaac

• Allergy & Immunology Physician in Harvey, LA
• Providers in Harvey, LA by specialty
• Allergy & Immunology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; 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.