Provider Demographics
NPI:1942897269
Name:LAFORTUNE, DANICA
Entity Type:Individual
Prefix:MRS
First Name:DANICA
Middle Name:
Last Name:LAFORTUNE
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 1:65 EVERGREEN AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-2338
Mailing Address - Country:US
Mailing Address - Phone:201-709-8108
Mailing Address - Fax:
Practice Address - Street 1:65 EVERGREEN AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-2338
Practice Address - Country:US
Practice Address - Phone:201-709-8108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula