Basic Information
| Provider Information | |||||||||
| NPI: | 1598086290 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LATT | ||||||||
| FirstName: | NYAN | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 LIPPINCOTT DR STE 120 | ||||||||
| Address2: | |||||||||
| City: | MARLTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080534197 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8563550340 | ||||||||
| FaxNumber: | 8563550330 | ||||||||
| Practice Location | |||||||||
| Address1: | 1601 HADDON AVE # A-1 | ||||||||
| Address2: | |||||||||
| City: | CAMDEN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081033109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8567573840 | ||||||||
| FaxNumber: | 8567573519 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2010 | ||||||||
| LastUpdateDate: | 05/07/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RT0003X | 25MA10867000 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Transplant Hepatology | 207RG0100X | ME128155 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RI0008X | 305251 | LA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hepatology |
No ID Information.