Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | F303922 | NY |
NPI | 1013069632 |
---|---|
Provider Name | Lawrence B Landphair |
First Address | New York, NY 10003 |
Second Address | New York, NY 10003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 08/07/2007 |