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NPI Code Detail

MEDICARE: JUAN JOEL LATORRE MD

MEDICARE: JUAN JOEL LATORRE MD
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
1207Q00000XFamily Medicine Physician25MA06218100NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1791932N2ZOTHERNJBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336227297
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUAN JOEL LATORRE MD
Provider Business Mailing Address
First Line : 122 CLINTON ST
Second Line :
City : HOBOKEN
State : NJ
Zip : 07030-2502
Country : US
Telephone Number : 201-418-3144
Fax Number : 201-418-3151
Provider Business Practice Location Address
First Line : 122 CLINTON ST
Second Line :
City : HOBOKEN
State : NJ
Zip : 07030-2502
Country : US
Telephone Number : 201-418-3144
Fax Number : 201-418-3151
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/08/2007

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Directions to “ JUAN JOEL LATORRE MD” Practice Location

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