Healthcare Provider Details

I. General information

NPI: 1518962158
Provider Name (Legal Business Name): MARIAN GAIL LANDAU D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 04/14/2023
Certification Date: 04/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 ANDERSON ST
PITTSBURGH PA
15212-5803
US

IV. Provider business mailing address

4516 BROWNS HILL ROAD
PITTSBURGH PA
15217
US

V. Phone/Fax

Practice location:
  • Phone: 412-322-4151
  • Fax:
Mailing address:
  • Phone: 412-422-7442
  • Fax: 412-904-5025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA-1234-03
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: