Healthcare Provider Details

I. General information

NPI: 1306864327
Provider Name (Legal Business Name): STEVEN H LANDERS MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 07/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 RIVERSIDE AVENUE
RED BANK NJ
07701-1063
US

IV. Provider business mailing address

176 RIVERSIDE AVENUE
RED BANK NJ
07701-1063
US

V. Phone/Fax

Practice location:
  • Phone: 732-224-6869
  • Fax: 732-224-0843
Mailing address:
  • Phone: 732-224-6869
  • Fax: 732-224-0843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35-085205
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: