MEDICARE: VINCENT LATTANZE

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
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1104764018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINCENT LATTANZE

Provider Business Mailing Address
First Line	:	1945 EASTCHESTER RD APT 23F
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-2189
Country	:	US
Telephone Number	:	703-595-7445
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 MORRIS PARK AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1900
Country	:	US
Telephone Number	:	703-595-7445
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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Directions to “ VINCENT LATTANZE ” Practice Location

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