Individual
DR. DANIEL JOHN LATENDRESSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
1657 BEDFORD AVE, SUITE 2A, BROOKLYN, NY 11225-2009
(718) 363-3261
(718) 363-5074
Mailing address
299 SAINT MARKS PL, APT 408, STATEN ISLAND, NY 10301-1859
(718) 744-4753
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
015946
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02607927
—
NY
Enumeration date
11/08/2006
Last updated
07/08/2007
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