Provider Demographics
NPI:1679975817
Name:MILANO, KERRY SR
Entity type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:MILANO
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 1:3544 W ESPLANADE AVE S
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-7130
Mailing Address - Country:US
Mailing Address - Phone:504-889-2300
Mailing Address - Fax:
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:70002-7130
Practice Address - Country:US
Practice Address - Phone:504-889-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.011341183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist