Provider Demographics
NPI:1891712584
Name:LATIFI, AFSANEH (DPM)
Entity Type:Individual
Prefix:DR
First Name:AFSANEH
Middle Name:
Last Name:LATIFI
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E 68TH ST
Mailing Address - Street 2:SUITE 1F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6047
Mailing Address - Country:US
Mailing Address - Phone:212-472-8872
Mailing Address - Fax:212-472-8873
Practice Address - Street 1:210 E 68TH ST
Practice Address - Street 2:SUITE 1F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6047
Practice Address - Country:US
Practice Address - Phone:212-472-8872
Practice Address - Fax:212-472-8873
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005286-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1891712584Medicare UPIN