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Individual
DR. ITAY TOKATLY LATZER
Active
Individual
DR. ITAY TOKATLY LATZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
292352
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MTN961241126
BLUE CROSS BLUE SHIELD (BCBS)
MA
Enumeration date
07/15/2022
Last updated
08/03/2022
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