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NPI Code Detail

MEDICARE: DAIANE TREVISAN LATOSINSKI PT

MEDICARE: DAIANE TREVISAN LATOSINSKI PT
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
1225100000XPhysical TherapistP16658NC
2225100000XPhysical Therapist070021362IL

General Provider Information

NPI Number : 1831567049
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAIANE TREVISAN LATOSINSKI PT
Provider Business Mailing Address
First Line : 210 MORAVIA LN
Second Line :
City : CARY
State : NC
Zip : 27513-5745
Country : US
Telephone Number : 630-575-6200
Fax Number :
Provider Business Practice Location Address
First Line : 510 TIMBER DR E STE 102
Second Line :
City : GARNER
State : NC
Zip : 27529-5285
Country : US
Telephone Number : 919-500-5003
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2015
Last Update Date : 12/18/2025

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