Provider Demographics
NPI:1801056585
Name:LAFORNARA, MICHELLE A (MD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:A
Last Name:LAFORNARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BROOKLINE PL
Mailing Address - Street 2:SUITE 423
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7224
Mailing Address - Country:US
Mailing Address - Phone:617-566-1535
Mailing Address - Fax:
Practice Address - Street 1:1 BROOKLINE PL
Practice Address - Street 2:SUITE 423
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7224
Practice Address - Country:US
Practice Address - Phone:617-566-1535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA235961207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology