Provider Demographics
NPI:1518420405
Name:LATYPOV, LENAR (MD)
Entity type:Individual
Prefix:DR
First Name:LENAR
Middle Name:
Last Name:LATYPOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 DOSORIS LN
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-1225
Mailing Address - Country:US
Mailing Address - Phone:516-676-1100
Mailing Address - Fax:
Practice Address - Street 1:141 DOSORIS LN
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-1225
Practice Address - Country:US
Practice Address - Phone:516-676-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-09
Last Update Date:2025-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program