Basic Information
| Provider Information | |||||||||
| NPI: | 1770834756 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LATORE | ||||||||
| FirstName: | DANIELLE | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MS ED | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3674 ATLANTIC AVE | ||||||||
| Address2: | |||||||||
| City: | FAIRPORT | ||||||||
| State: | NY | ||||||||
| PostalCode: | 144509160 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5856784921 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 41 COLEBROOK DR | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146172211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5854674567 | ||||||||
| FaxNumber: | 5854676973 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2012 | ||||||||
| LastUpdateDate: | 10/01/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | Other Service Providers | Specialist |
No ID Information.