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NPI Code Detail

MEDICARE: MR. SEBASTIAN LATTUGA MD FACOS

MEDICARE: MR. SEBASTIAN LATTUGA MD FACOS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XS0117XOrthopaedic Surgery of the Spine Physician1870781NY

General Provider Information

NPI Number : 1073508933
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SEBASTIAN LATTUGA MD FACOS
Provider Business Mailing Address
First Line : 2001 MARCUS AVE
Second Line : STE 170 W NEW YORK SPECIALISTS LLP
City : LAKE SUCCESS
State : NY
Zip : 11042-1011
Country : US
Telephone Number : 516-355-0111
Fax Number : 516-355-5457
Provider Business Practice Location Address
First Line : 2001 MARCUS AVE
Second Line : STE 170 W NEW YORK SPECIALISTS LLP
City : LAKE SUCCESS
State : NY
Zip : 11042-1011
Country : US
Telephone Number : 516-355-0111
Fax Number : 516-355-5457
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2005
Last Update Date : 07/08/2007

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