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NPI Code Detail

MEDICARE: MICHELLE A. LATIMER N.P.P.

MEDICARE: MICHELLE A. LATIMER N.P.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner400934NY

General Provider Information

NPI Number : 1154499390
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE A. LATIMER N.P.P.
Provider Business Mailing Address
First Line : 73 COOPER ST
Second Line : #3B
City : NEW YORK
State : NY
Zip : 10034-3070
Country : US
Telephone Number : 646-873-0621
Fax Number :
Provider Business Practice Location Address
First Line : 1545 INWOOD AVE
Second Line :
City : BRONX
State : NY
Zip : 10452-2001
Country : US
Telephone Number : 718-299-5500
Fax Number : 718-299-7679
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2006
Last Update Date : 07/08/2007

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