Provider Demographics
NPI:1205284353
Name:LALANNE, SHA-MEIK
Entity type:Individual
Prefix:MRS
First Name:SHA-MEIK
Middle Name:
Last Name:LALANNE
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 1:180 LAFAYETTE AVE APT 1E
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-4735
Mailing Address - Country:US
Mailing Address - Phone:646-323-0132
Mailing Address - Fax:
Practice Address - Street 1:180 LAFAYETTE AVE APT 1E
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-4735
Practice Address - Country:US
Practice Address - Phone:646-323-0132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097679104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker