| Doctor Name: | ANNMARIE ASIS LATHAM |
| NPI Number: | 1982048849 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | MA056009 |
| Business Practice Address: | 499 Beckett Rd Suite 201 Logan Township, NJ - 080851766 |
| Business Phone Number: | 8564676400 |
| Business Fax Number: | 8564671033 |
| Mailing Address: | 499 Beckett Rd, Suite 201 LOGAN TOWNSHIP |
| State: | NJ |
| Postal Code: | 080851766 |
| Phone Number: | 8564676400 |
| Fax Number: | 8564671033 |
| NPI Enumeration Date: | 04/23/2013 |
| NPI Last Update Date: | 10/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | MA056009 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |