Provider Demographics
NPI:1003855859
Name:ALTSCHUL-LATZMAN, AIMEE S (MD)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:S
Last Name:ALTSCHUL-LATZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 SHERMAN ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5849
Mailing Address - Country:US
Mailing Address - Phone:203-955-1461
Mailing Address - Fax:203-955-1464
Practice Address - Street 1:140 SHERMAN ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5849
Practice Address - Country:US
Practice Address - Phone:203-955-1461
Practice Address - Fax:203-955-1464
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207617174400000X
CT040346207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No174400000XOther Service ProvidersSpecialist