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Organization
LATHA THANEER MEDICAL PC
Active
Organization
LATHA THANEER MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATHA THANNEER M.D. (OWNER)
(914) 803-2554
Entity
Organization
Contact information
Practice address
14 BELLEFAIR RD, RYE BROOK, NY 10573-5507
(914) 803-2554
Mailing address
14 BELLEFAIR RD, RYE BROOK, NY 10573-5507
(914) 803-2554
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
219789
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02791688
—
NY
01
—
219789
STATE LICENSE
NY
Enumeration date
09/10/2012
Last updated
09/10/2012
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