Healthcare Provider Details
I. General information
NPI: 1093759003
Provider Name (Legal Business Name): RICHARD LANDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/16/2006
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
261 JAMES ST STE 1G
MORRISTOWN NJ
07960-6348
US
IV. Provider business mailing address
401 ROUTE 73 N BLDG 10, SUITE 320
MARLTON NJ
08053
US
V. Phone/Fax
- Phone: 973-540-9393
- Fax: 973-540-1937
- Phone: 856-872-7055
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 25MA03209300 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080A0000X |
| Taxonomy | Pediatric Adolescent Medicine Physician |
| License Number | 25MA03209300 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: