Provider Demographics
NPI:1235940057
Name:BANAC-ARICAYOS, ULLA
Entity type:Individual
Prefix:
First Name:ULLA
Middle Name:
Last Name:BANAC-ARICAYOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6375 LOUIS XIV ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-3133
Mailing Address - Country:US
Mailing Address - Phone:504-261-4913
Mailing Address - Fax:
Practice Address - Street 1:6375 LOUIS XIV ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-3133
Practice Address - Country:US
Practice Address - Phone:504-261-4913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier