Individual ProviderLatoya BettonNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2015 Grand Concourse, Bronx, NY 10453-4303(718) 299-7295(718) 618-0401PECOS EnrollmentBased on the most recent information from CMS, provider Latoya Betton is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1003170275Provider TypeIndividualFull NameBetton, LatoyaCredentialNPGenderFemaleSole ProprietorYesEnumeration Date7/2/2012Last Updated10/3/2019Contact InformationPractice LocationPractice Address2015 Grand Concourse, Bronx, NY 10453-4303Phone(718) 299-7295Fax(718) 299-6797Mailing LocationMailing Address1434 Williamsbridge Rd, Bronx, NY 10461-2507Phone(718) 618-0401Fax(347) 479-1303Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseF343094New YorkCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicense646922New York