Healthcare Provider Details

I. General information

NPI: 1689287781
Provider Name (Legal Business Name): JENNIFER LATTERI PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 SLEEPY HOLLOW DR STE 100
MIDDLETOWN DE
19709-5838
US

IV. Provider business mailing address

2099 NEW ALBANY RD
CINNAMINSON NJ
08077-3534
US

V. Phone/Fax

Practice location:
  • Phone: 302-291-9900
  • Fax: 302-200-9094
Mailing address:
  • Phone: 302-291-9900
  • Fax: 302-200-9094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberC5-0011421
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: