Provider Demographics
NPI:1982646311
Name:LATIF, SYED A (PHD)
Entity Type:Individual
Prefix:DR
First Name:SYED
Middle Name:A
Last Name:LATIF
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 SUMMIT AVE
Mailing Address - Street 2:DEPARTMENT OF PATHOLOGY
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-2853
Mailing Address - Country:US
Mailing Address - Phone:401-793-4272
Mailing Address - Fax:401-444-8514
Practice Address - Street 1:164 SUMMIT AVE
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-2853
Practice Address - Country:US
Practice Address - Phone:401-793-4272
Practice Address - Fax:401-444-8514
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILS00607246QC1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QC1000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyChemistry