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General NPI Number Information
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NPI Number | 1124323712
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Entity Type | Individual
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Provider Name | MIGUEL LANDRON DPT
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Gender | Male
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Dates
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Enumeration Date | 01/13/2011
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Last Update Date | 06/13/2017
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Provider Practice Location Address
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Address Line | 17232 HIGHLAND AVE
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City | JAMAICA
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State | NY
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Zip | 11432-2862
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Country | US
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Telephone | 808-280-7311
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Fax |
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Provider Business Mailing Address
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Address Line | 172-32 HIGHLAND AVE
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City | JAMAICA
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State | NY
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Zip | 11432
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Country | US
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Telephone |
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Fax |
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT-3025
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 038858-1
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License Number State | NY
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