Organization
MARK A. LATINA
Active
Other names
Advanced Glaucoma Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A LATINA MD (OWNER)
(781) 941-9876
Entity
Organization
Contact information
Practice address
20 PONDMEADOW DRIVE, SUITE 203, READING, MA 01867
(781) 942-9876
(781) 942-9877
Mailing address
20 PONDMEADOW DRIVE, SUITE 203, READING, MA 01867
(781) 942-9876
(781) 942-9877
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207W00000X
Ophthalmology Physician
Primary
48630
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
607152
TUFTS HEALTH PLAN GROUP N
MA
01
—
8488
FALLON
—
05
—
9777865
—
MA
05
—
977865
—
MA
01
—
M16360
BC/BS GROUP NUMBER
MA
Enumeration date
02/11/2006
Last updated
12/02/2010
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