Individual
JOSE LATORRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
471 BARNUM AVE, BRIDGEPORT, CT 06608-2409
(203) 333-6864
(203) 332-0376
Mailing address
471 BARNUM AVE, BRIDGEPORT, CT 06608-2409
(203) 333-6864
(203) 332-0376
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
002973
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002973
STAE LICENSE
CT
Enumeration date
07/21/2005
Last updated
01/08/2010
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