Provider Demographics
NPI:1932247483
Name:LAPORTA, GINA MARIA (DC)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:MARIA
Last Name:LAPORTA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:682 POMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-1230
Mailing Address - Country:US
Mailing Address - Phone:973-239-2225
Mailing Address - Fax:
Practice Address - Street 1:682 POMPTON AVE
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-1230
Practice Address - Country:US
Practice Address - Phone:973-239-2225
Practice Address - Fax:973-857-9496
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00316100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJLA589161Medicare ID - Type Unspecified