Mara Haseltine MD LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

MARA HASELTINE MD LLC

Practice address

3100 Galleria Dr Ste 203
Metairie, LA 70001-2196

Phone

(504) 226-7873

Fax

(504) 704-1639

NPI assigned

Apr 10, 2019

Organization subpart

No

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

Authorized official

Name

Mara Haseltine, MD

Title

Owner

Phone

(504) 226-7873

Specialties & licenses 1

Addresses

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cherie Montero Albro, FNP

  • Family Nurse Practitioner
  • New Orleans, LA
  • NPI 1679027494
  NPD
• Katherine Zibilich Holcomb, M.D.

  • Dermatology Physician
  • Metairie, LA
  • NPI 1861668808
  NPD
• Donna Lynn Lackore Swanson, PA-C

  • Physician Assistant
  • Alexandria, VA
  • NPI 1699789859
  NPD (past)

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554854400000",
    "number": "1821551573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4921 BARONNE ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701154922",
            "telephone_number": "504-226-7873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 GALLERIA DR STE 203",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700012196",
            "telephone_number": "504-226-7873",
            "fax_number": "504-704-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARA HASELTINE MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-10",
        "last_updated": "2019-04-10",
        "status": "A",
        "authorized_official_last_name": "HASELTINE",
        "authorized_official_first_name": "MARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-226-7873",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenisha Hampton Manuel, FNP-C
• Nicole D Manuel
• Rhanaja Manuel
• Jessica L Manzella, LOTR, CHT
• Brennan Victoria Maples
• Marc S. Glovinsky, DPM, LLC
• Victoria Marcel, PA
• Aiyana Marcia
• Sharee Encalade Marconi, FNP-C
• Marcus K. Jackson, DDS, a Professional Dental Corporation

• Dermatology Physician in Metairie, LA
• Providers in Metairie, LA by specialty
• Dermatology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; 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.