NPI Code Detail JSON Logo

1700248705 NPI number — GWYNNE EVANS LATIMER MD

NPI Number: 1700248705
Health Care Provider/Practitioner: GWYNNE EVANS LATIMER MD

Information about “1700248705” NPI (GWYNNE EVANS LATIMER MD) exists in 1700248705 in HTML format HTML  |  1700248705 in plain Text format TXT  |  1700248705 in PDF (Portable Document Format) PDF  |  1700248705 in an XML format XML  formats.

NPI Number : 1700248705 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1700248705",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LATIMER",
    "FirstName": "GWYNNE",
    "MiddleName": "EVANS",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "EVANS",
    "OtherFirstName": "GWYNNE",
    "OtherMiddleName": "MEGAN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "3959 BROADWAY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NEW YORK",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "10032-1559",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "212-305-8504",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3959 BROADWAY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEW YORK",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10032-1559",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "212-305-8504",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/28/2016",
    "LastUpdateDate": "10/13/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "390200000X",
          "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2080P0203X",
          "TaxonomyName": "Pediatric Critical Care Medicine Physician",
          "LicenseNumber": "295414",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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