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NPI Code Detail

MEDICARE: MR. STEVEN LATTANZI CP, COA

MEDICARE: MR. STEVEN LATTANZI CP, COA
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
1224P00000XProsthetistPO000211PA

General Provider Information

NPI Number : 1386185395
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEVEN LATTANZI CP, COA
Provider Business Mailing Address
First Line : 3435 BOX HILL CORPORATE CENTER DR
Second Line : SUITE D
City : ABINGDON
State : MD
Zip : 21009-1204
Country : US
Telephone Number : 410-569-0606
Fax Number : 410-569-7477
Provider Business Practice Location Address
First Line : 3435 BOX HILL CORPORATE CENTER DR
Second Line : SUITE D
City : ABINGDON
State : MD
Zip : 21009-1204
Country : US
Telephone Number : 410-569-0606
Fax Number : 410-569-7477
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2017
Last Update Date : 03/10/2017

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