Provider Demographics
NPI:1326854449
Name:LATEH, CORNELIA
Entity type:Individual
Prefix:
First Name:CORNELIA
Middle Name:
Last Name:LATEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8625 ANNAPOLIS RD
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3107
Mailing Address - Country:US
Mailing Address - Phone:202-940-7490
Mailing Address - Fax:
Practice Address - Street 1:8625 ANNAPOLIS RD
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3107
Practice Address - Country:US
Practice Address - Phone:202-940-7490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-04
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide