Khin M Latt, M.D.
Individual provider Active NPI Psychiatry Physician · Yaphank, NY
NPI 1104044486 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104044486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 102875-1 (NY)
- Practice address
- 14 Glover Dr
Yaphank, NY 11980-1204 - Phone
- (631) 852-4400
- Fax
- (631) 852-4414
- NPI assigned
- Apr 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102875-1 | NY | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Suffolk | Past | Accepting new patients | |
| County of Suffolk | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 102875-1 | NY | Yes |
Addresses
Primary practice location
14 Glover Dr
Yaphank, NY 11980-1204
Mailing address
11 Shields CT
Brookhaven, NY 11719-9309
Phone (631) 286-6124
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00623872 | Medicaid | NY |
Other providers in Yaphank, NY
- Chelsea Howard
- Rochelle John
- Gail Kellner
- Margaret Bovaird Kilmer
- Bryan Scott Knoell
- Richard Joseph Lopez
- Nicole Marengo
- Coryn Martin
- Emily Lynn Martino
- Maryhaven Center of Hope Inc.
All providers in Yaphank, NY · Psychiatry Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.