Healthcare Provider Details

I. General information

NPI: 1285469486
Provider Name (Legal Business Name): D'ANNA LATESHA LITTLE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VIA DELLA FORNACE 14
PORCIA PORDENONE FVG
33080
IT

IV. Provider business mailing address

VIA DELLA FORNACE 14 INT. 19
PORCIA PORDENONE FVG
33080
IT

V. Phone/Fax

Practice location:
  • Phone: 301-968-6775
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number320378
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number320378
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: