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General NPI Number Information
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NPI Number | 1083893770
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Entity Type | Individual
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Provider Name | GENNADY LANDA M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 321 E 13TH ST APT 7A
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City | NEW YORK
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State | NY
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Zip | 10003-5818
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Country | US
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Telephone | 646-717-0517
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Fax |
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Provider Business Mailing Address
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Address Line | 321 E 13TH ST APT 7A
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City | NEW YORK
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State | NY
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Zip | 10003-5818
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Country | US
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Telephone | 212-614-8312
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Fax | 212-614-8363
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | 262738
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 262738
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License Number State | NY
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