Dr. Miro Lati, D.O.
Family Medicine in Staten Island, NY. Individual provider (NPI-1).
NPI number1154776367
StatusActive
Last updated in NPPESAug 28, 2025
Details
- NPI
- 1154776367
- Entity type
- Individual (NPI-1)
- Name
- Dr. Miro Lati
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 26, 2016
- Certification date
- Aug 28, 2025
- Last updated
- Aug 28, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 284309 | NY | Yes |
Practice location
1432 Hylan BlvdStaten Island, NY 10305-1923
Phone 718-238-6161 · Fax 718-238-6194
Mailing address
6903 4th AveBrooklyn, NY 11209-1509
Phone 718-238-6161
Other practice locations
6903 4th Ave
Brooklyn, NY 11209-1509
Brooklyn, NY 11209-1509
Phone 718-238-6161
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