Healthcare Provider Details

I. General information

NPI: 1457599615
Provider Name (Legal Business Name): KAREN LATIMER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 01/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 W 110TH ST
NEW YORK NY
10025-2086
US

IV. Provider business mailing address

535 W 110TH ST
NEW YORK NY
10025-2086
US

V. Phone/Fax

Practice location:
  • Phone: 212-280-4790
  • Fax:
Mailing address:
  • Phone: 212-280-4790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number220315-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: