MEDICARE: VILLI LANDMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	291169	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366067407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VILLI LANDMAN

Provider Business Mailing Address
First Line	:	520 E 2ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-4504
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 E 2ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-4504
Country	:	US
Telephone Number	:	917-589-7216
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2020
Last Update Date	:	06/15/2020

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Directions to “ VILLI LANDMAN ” Practice Location

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