Basic Information
Provider Information
NPI: 1194960351
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LABORDE
FirstName: ELVE
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 107 WEST 4TH STREET
Address2: MOUNT VERNON NEIGHBORHOOD HEALTH CENTER
City: MOUNT VERNON
State: NY
PostalCode: 10550
CountryCode: US
TelephoneNumber: 9146997200
FaxNumber: 9146990837
Practice Location
Address1: 107 WEST 4TH STREET
Address2: MOUNT VERNON NEIGHBORHOOD HEALTH CENTER
City: MOUNT VERNON
State: NY
PostalCode: 10550
CountryCode: US
TelephoneNumber: 9146997200
FaxNumber: 9146990837
Other Information
ProviderEnumerationDate: 12/02/2008
LastUpdateDate: 05/04/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X046771CTY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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