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General NPI Number Information
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NPI Number | 1154449924
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Entity Type | Organization
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Legal Business Name | JOSEPH LANDISI
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 09/11/2014
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Provider Practice Location Address
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Address Line | 1750 CROSBY AVE
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City | BRONX
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State | NY
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Zip | 10461
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Country | US
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Telephone | 718-892-1522
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Fax | 718-892-1523
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Provider Business Mailing Address
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Address Line | 1750 CROSBY AVE
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City | BRONX
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State | NY
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Zip | 10461
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Country | US
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Telephone | 718-892-1522
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Fax | 718-892-1523
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. JOSEPH MICHAEL LANDISI
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Credential | DMD
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Telephone | 718-892-1522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 041299
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License Number State | NY
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