Provider Demographics
NPI:1942346333
Name:LATRENTA, GREGORY S (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:S
Last Name:LATRENTA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1150 PARK AVE
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1244
Mailing Address - Country:US
Mailing Address - Phone:212-369-5300
Mailing Address - Fax:212-369-6985
Practice Address - Street 1:1150 PARK AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1244
Practice Address - Country:US
Practice Address - Phone:212-369-5300
Practice Address - Fax:212-369-6985
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY149890208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB10292Medicare UPIN