Provider Demographics
NPI:1043258395
Name:MACALUSO, ANTHONY JOSEPH (PT)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:MACALUSO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10421 PARK ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70123-1317
Mailing Address - Country:US
Mailing Address - Phone:504-738-2908
Mailing Address - Fax:504-865-8379
Practice Address - Street 1:714 DUBLIN ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-1022
Practice Address - Country:US
Practice Address - Phone:504-861-4693
Practice Address - Fax:504-865-8379
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA00867225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5CE54Medicare ID - Type Unspecified