Healthcare Provider Details

I. General information

NPI: 1700414638
Provider Name (Legal Business Name): PASCALE GLORIA LAFORTUNE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 PULASKI RD STE D
GREENLAWN NY
11740-1605
US

IV. Provider business mailing address

410 LAKEVILLE RD STE 200
NEW HYDE PARK NY
11042-1103
US

V. Phone/Fax

Practice location:
  • Phone: 631-427-6060
  • Fax:
Mailing address:
  • Phone: 516-708-2520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number327567
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number327567
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: