Provider Demographics
NPI:1053420398
Name:LORENZO-LATKANY, MONICA (MD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:LORENZO-LATKANY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E 38TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2709
Mailing Address - Country:US
Mailing Address - Phone:212-687-0265
Mailing Address - Fax:212-687-3463
Practice Address - Street 1:225 E 38TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2709
Practice Address - Country:US
Practice Address - Phone:212-687-0265
Practice Address - Fax:212-687-3463
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1922891207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG36037Medicare UPIN
NY212531Medicare ID - Type Unspecified