Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | OSO19520 | PA |
Y | 207QA0401X | Family Doctor - Addiction Medicine | OSO19520 | PA |
NPI | 1730609157 |
---|---|
Provider Name | Dr. James Robert Latronica |
First Address | Hershey, PA 17033-2360 |
Second Address | Hershey, PA 17033-2360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2017 |
Last Update Date | 01/03/2021 |