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General NPI Number Information
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NPI Number | 1609347335
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Entity Type | Organization
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Legal Business Name | THEATRE SURGICAL ARTS OFFICE BASED SURGERY, PC
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Dates
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Enumeration Date | 12/06/2018
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 994 W JERICHO TPKE STE 102
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City | SMITHTOWN
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State | NY
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Zip | 11787-3211
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Country | US
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Telephone | 631-864-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 994 W JERICHO TPKE STE 102
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City | SMITHTOWN
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State | NY
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Zip | 11787-3211
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Country | US
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Telephone | 631-864-4111
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LLOYD DAVID LANDSMAN
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Credential | MD
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Telephone | 631-864-4111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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