Provider Demographics
NPI:1235966623
Name:FARNET, ANDRE J SR
Entity type:Individual
Prefix:
First Name:ANDRE
Middle Name:J
Last Name:FARNET
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 ALEXANDER DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-2602
Mailing Address - Country:US
Mailing Address - Phone:504-475-7508
Mailing Address - Fax:
Practice Address - Street 1:4700 ALEXANDER DR
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003-2602
Practice Address - Country:US
Practice Address - Phone:504-475-7508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA568168171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications