Individual
KERRIANN LATTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2500 NESCONSET HWY BLDG 14, STONY BROOK, NY 11790-2555
(316) 896-2266
(631) 675-0736
Mailing address
2500 NESCONSET HWY BLDG 14, STONY BROOK, NY 11790-2555
(631) 689-6226
(631) 675-0736
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
342196
NY
363LF0000X
Family Nurse Practitioner
342196
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04966625
—
NY
Enumeration date
08/08/2017
Last updated
03/01/2024
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