Provider Demographics
NPI:1598086290
Name:LATT, NYAN LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:NYAN
Middle Name:LYNN
Last Name:LATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:301 LIPPINCOTT DR STE 120
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:1601 HADDON AVE # A-1
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-3109
Practice Address - Country:US
Practice Address - Phone:856-757-3840
Practice Address - Fax:856-757-3519
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA10867000207RT0003X
FLME128155207RG0100X
LA305251207RI0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RT0003XAllopathic & Osteopathic PhysiciansInternal MedicineTransplant Hepatology
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology