Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 000839 | CT |
Y | 222Z00000X | Podiatrist | 000839 | CT |
N | 213ES0103X | Foot & Ankle Surgery | 25MD00294100 | NJ |
NPI | 1043488422 |
---|---|
Provider Name | Dr. Ayman Maurice Latif |
First Address | Middletown, CT 06457-4743 |
Second Address | Middletown, CT 06457-4743 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2008 |
Last Update Date | 13/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4997100002 | NSC PROVIDER# (01) | CT |
4997100006 | NSC PROVIDER# (01) | CT |