Provider Demographics
NPI:1184697468
Name:LATTARULO, FRANK J (DPM)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:J
Last Name:LATTARULO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 SOUTH CENTRAL AVENUE
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523
Mailing Address - Country:US
Mailing Address - Phone:914-345-3400
Mailing Address - Fax:914-345-3481
Practice Address - Street 1:160 SOUTH CENTRAL AVENUE
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523
Practice Address - Country:US
Practice Address - Phone:914-345-3400
Practice Address - Fax:914-345-3481
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003577213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP39052Medicare ID - Type Unspecified
NYT51191Medicare UPIN