Provider Demographics
NPI:1679803951
Name:LA PORTE, SHAR AILI (CNM)
Entity Type:Individual
Prefix:
First Name:SHAR
Middle Name:AILI
Last Name:LA PORTE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 47TH AVE
Mailing Address - Street 2:APT #5
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101
Mailing Address - Country:US
Mailing Address - Phone:917-903-2898
Mailing Address - Fax:
Practice Address - Street 1:1125 47TH AVE
Practice Address - Street 2:APT #5
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-5467
Practice Address - Country:US
Practice Address - Phone:917-903-2898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-08
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001372282NW0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NW0100XHospitalsGeneral Acute Care HospitalWomen