Provider Demographics
NPI:1316921588
Name:LATTMAN, JESSICA (MD)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:LATTMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E 61ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:11021
Mailing Address - Country:US
Mailing Address - Phone:212-832-5456
Mailing Address - Fax:212-421-0176
Practice Address - Street 1:115 EAST 61ST STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:11021
Practice Address - Country:US
Practice Address - Phone:212-832-5456
Practice Address - Fax:212-421-0176
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY201144207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0801229OtherMEDICARE COMPLETE
201144OtherHIP EPO PPO
7343028002OtherCIGNA PPO GPPO HMO
P51053942OtherMULTIPLAN
010201144NY01OtherHORIZON HEALTHCARE OF NY
NY02088122Medicaid
2C9341OtherHEALTHNET
92T912OtherBC HMO EPO POS CHILD HLTH
0499796OtherGHI
0005065597OtherAETNA PPO EPO MNGEDCHOICE
0005065597OtherAETNA HMO
P1041236OtherOXFORD
0801229OtherMEDICARE COMPLETE
2C9341OtherHEALTHNET