Provider Demographics
NPI:1497417430
Name:LATHAM, YULANDIE (RN)
Entity Type:Individual
Prefix:
First Name:YULANDIE
Middle Name:
Last Name:LATHAM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19020 109TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-1125
Mailing Address - Country:US
Mailing Address - Phone:515-828-1808
Mailing Address - Fax:516-828-2386
Practice Address - Street 1:19020 109TH AVE
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-1125
Practice Address - Country:US
Practice Address - Phone:515-828-1808
Practice Address - Fax:516-828-2386
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY585017207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine