Individual
DR. ITAY TOKATLY LATZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 735-6000
Mailing address
14 ALTON CT APT 3, BROOKLINE, MA 02446-6728
(781) 531-0481
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
292352
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MTN961241126
BLUE CROSS BLUE SHIELD (BCBS)
MA
Enumeration date
07/15/2022
Last updated
08/03/2022
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