Latourrette, Evan Thomas

Latourrette, Evan Thomas is an sole proprietor health care provider with primary practice located at 382 Rosevale Ave , Ronkonkoma NY 11779-3069. He recently has 5 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Foot Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine. Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine is his primary health care specialty. Latourrette, Evan Thomas can be contacted via phone (631) 667-0388.

Contact Information

Primary practice address
382 Rosevale Ave Ronkonkoma NY 11779-3069
Phone: (631) 667-0388
Fax: (631) 968-7705
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X N007080-1 New York
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X N007080 New York
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X N007080-1 New York
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X N007080-1 New York
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X N007080-1 New York

Profile Details

NPI number 1396266516
LBN Legal business name Latourrette, Evan Thomas
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 28th, 2017
Last updated Jul 15th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396266516 NPPES
New York MEDICAID B1386739514
New York MEDICAID ETINAD01

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