Daniel John Latendresse, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

015946 Issued in NY

Practice address

1657 Bedford Ave
Suite 2a
Brooklyn, NY 11225-2009

Phone

(718) 363-3261

Fax

(718) 363-5074

NPI assigned

Nov 8, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841360112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 SAINT MARKS PL",
            "address_2": "APT 408",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103011859",
            "telephone_number": "718-744-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1657 BEDFORD AVE",
            "address_2": "SUITE 2A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112252009",
            "telephone_number": "718-363-3261",
            "fax_number": "718-363-5074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATENDRESSE",
        "first_name": "DANIEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02607927",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Philena S Latcha, ATC
• Kamal Cecil Latchman Jr.
• Sundesh Latchman
• Hanna Lateef, MD
• Hannah Lategan, MD
• Asha Latham, CF-SLP
• Prabodh M. Lathigara, D.D.S.
• Isaac Lati, MD
• Nicole Lauren Lati, OTR/L
• Rechel Lati

• Clinical Psychologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.