Individual
ALICIA LATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065
(646) 888-4050
Mailing address
1275 YORK AVE, NEW YORK, NY 10065-6007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
293665
NY
207SG0201X
Clinical Genetics (M.D.) Physician
293665
NY
Other
Enumeration date
06/14/2013
Last updated
10/23/2019
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