Active NPI
Shana Laborde, M.D.
- General Practice Physician
- Bronx, NY
National Provider Identifier
1962856328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- P01015
- Practice address
- 1265 Fulton Ave
Bronx, NY 10456-3401 - Phone
- (718) 579-7000
- Fax
- (718) 299-6797
- NPI assigned
- Apr 21, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | P01015 | NY | Primary |
Addresses
Primary practice location
1265 Fulton Ave
Bronx, NY 10456-3401
Mailing address
3198 Grand Concourse
Bronx, NY 10458-1000
Phone (718) 618-0401
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P01015 | NY | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493856000000",
"number": "1962856328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3198 GRAND CONCOURSE",
"city": "BRONX",
"state": "NY",
"postal_code": "104581000",
"telephone_number": "718-618-0401",
"fax_number": "718-795-4394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1265 FULTON AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104563401",
"telephone_number": "718-579-7000",
"fax_number": "718-299-6797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LABORDE",
"first_name": "SHANA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-21",
"last_updated": "2017-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "NY",
"license": "P01015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.