Individual
DR. ALEX ANDREW LATYSHEVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
150 55TH ST, LMC PHYSICIAN SERVICES P.C., BROOKLYN, NY 11220-2559
(718) 630-7000
(718) 630-8515
Mailing address
5800 3RD AVE, MANAGED CARE DEPARTMENT, BROOKLYN, NY 11220-3702
(718) 630-7477
(718) 630-7437
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
146304
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01284555
—
NY
Enumeration date
09/16/2006
Last updated
07/08/2007
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