Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 27796 | CO |
NPI | 1023171238 |
---|---|
Provider Name | Dr. Bruce Landy |
First Address | Parker, CO 80138-4603 |
Second Address | Parker, CO 80138-4603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 03/07/2014 |