Individual
LATIEMA MERILUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6 WESMONT DR, WOOD RIDGE, NJ 07075-2152
(201) 500-6992
(833) 605-4359
Mailing address
99 WALL ST STE 1571, NEW YORK, NY 10005-4301
(646) 420-7824
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ14918600
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
405146
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1049666
—
NJ
Enumeration date
07/31/2023
Last updated
04/24/2025
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