Individual
MRS. JENNIFER ANN LAPORTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
766 SHREWSBURY AVE BLDG SUITE101, TINTON FALLS, NJ 07724-3001
(732) 945-2009
(732) 747-8697
Mailing address
766 SHREWSBURY AVE BLDG SUITE101, TINTON FALLS, NJ 07724-3001
(732) 945-2009
(732) 747-8697
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA10005700
NJ
207Q00000X
Family Medicine Physician
287545
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04782743
—
NY
05
—
0685984
—
NJ
01
—
823848
MEDICARE
NJ
01
—
A400174459
MEDICARE
NY
Enumeration date
04/07/2014
Last updated
09/28/2020
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