Healthcare Provider Details

I. General information

NPI: 1437160504
Provider Name (Legal Business Name): MEENAKSHI LA CORTE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEENAKSHI GULRAJANI M.D.

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

699 92ND ST
BROOKLYN NY
11228-3619
US

IV. Provider business mailing address

31 HYLAN BLVD APT 11D
STATEN ISLAND NY
10305-2000
US

V. Phone/Fax

Practice location:
  • Phone: 718-567-1089
  • Fax:
Mailing address:
  • Phone: 718-720-1829
  • Fax: 718-720-1829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number141298
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: