| NPI | 1508456708 |
|---|---|
| Doing Business As | LATHAM COVID VACCINE CENTER |
| Entity Type | Organization |
| Authorized Contact | DEBBY COONS Credentialing Manager 518-213-0478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 208600000X Surgery | |
| 208D00000X General Practice | |
| Enumeration Date | 2021-01-21 |
| Last Update Date | 2022-07-29 |