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General NPI Number Information
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NPI Number | 1740141225
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Entity Type | Individual
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Provider Name | SHAYNA LASALA NP
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Gender | Female
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 55 E 87TH ST STE 1F
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City | NEW YORK
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State | NY
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Zip | 10128-1049
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Country | US
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Telephone | 212-280-4740
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Fax |
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Provider Business Mailing Address
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Address Line | 103 STATE PARK RD
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City | CHESTER
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State | NJ
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Zip | 07930-3217
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Country | US
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Telephone | 908-246-3334
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 357710
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License Number State | NY
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