Provider Demographics
NPI:1134745938
Name:BODY MORPH MEDICAL WEIGHT LOSS SERVICES
Entity type:Organization
Organization Name:BODY MORPH MEDICAL WEIGHT LOSS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-391-1274
Mailing Address - Street 1:7 OLD WOODS DR
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-2420
Mailing Address - Country:US
Mailing Address - Phone:914-391-1274
Mailing Address - Fax:
Practice Address - Street 1:1086 N BROADWAY STE 50
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1115
Practice Address - Country:US
Practice Address - Phone:914-375-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity MedicineGroup - Multi-Specialty