Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | N005031 | NY |
NPI | 1093715633 |
---|---|
Provider Name | Dr. Robert J Landy |
First Address | West Islip, NY 11795-4429 |
Second Address | West Islip, NY 11795-4429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2005 |
Last Update Date | 25/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01477669 | (05) | NY |
U43159 | (02) | NY |