Doctor Name: | DR. MOHAMED A LATEEF |
NPI Number: | 1184746216 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 25MA03315400 |
Business Practice Address: | 90 Cedar St Ridgefield Park, NJ - 076601745 |
Business Phone Number: | 2014405060 |
Business Fax Number: | |
Mailing Address: | 90 Cedar St, RIDGEFIELD PARK |
State: | NJ |
Postal Code: | 076601745 |
Phone Number: | 2014405060 |
Fax Number: | |
NPI Enumeration Date: | 04/06/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 25MA03315400 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |