Provider Demographics
NPI:1609694124
Name:MILANO, DIANE G (RPH)
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:G
Last Name:MILANO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3544 W ESPLANADE AVE
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-3225
Mailing Address - Country:US
Mailing Address - Phone:504-889-2300
Mailing Address - Fax:504-887-7661
Practice Address - Street 1:3544 W ESPLANADE AVE S
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-3225
Practice Address - Country:US
Practice Address - Phone:504-889-2300
Practice Address - Fax:504-887-7661
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA157IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2204866Medicaid