Provider Demographics
NPI:1346254638
Name:LATORA, PAUL ANGELO (DPM)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ANGELO
Last Name:LATORA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:312 BELLEVILLE TPKE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:NORTH ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07031-6463
Mailing Address - Country:US
Mailing Address - Phone:201-998-3668
Mailing Address - Fax:201-997-6610
Practice Address - Street 1:312 BELLEVILLE TPKE
Practice Address - Street 2:SUITE 1B
Practice Address - City:NORTH ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07031-6463
Practice Address - Country:US
Practice Address - Phone:201-998-3668
Practice Address - Fax:201-997-6610
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MD00187600213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1840606Medicaid
NJ1840606Medicaid
NJ546395Medicare PIN