Healthcare Provider Details

I. General information

NPI: 1053250316
Provider Name (Legal Business Name): CHRISTINE LATTANZIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 LAWRENCE ST NE
WASHINGTON DC
20017-3513
US

IV. Provider business mailing address

5405 GOSHAWK ALY
BETHESDA MD
20816-1525
US

V. Phone/Fax

Practice location:
  • Phone: 202-635-5900
  • Fax:
Mailing address:
  • Phone: 917-744-5980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: