Individual
LATIFA JANICE JALALI DEGRAFT-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
228 PARK AVE S # 76071, NEW YORK, NY 10003-1502
(646) 863-1411
(305) 363-5044
Mailing address
450 W 42ND ST APT 39D, NEW YORK, NY 10036-6881
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
237874
NY
207Q00000X
Family Medicine Physician
ME105724
FL
Other
Enumeration date
05/17/2006
Last updated
10/29/2024
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