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NPI 1780706184

NPI 1780706184 : DORIS LANDAU FINE PT PHD : BRIGHTON, MA

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General NPI Number Information
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    NPI Number           |    1780706184
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    Entity Type          |    Individual 
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    Provider Name        |    DORIS LANDAU FINE PT PHD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/04/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    30 WARREN ST 
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    City                 |    BRIGHTON
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    State                |    MA
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    Zip                  |    02135-3602
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    Country              |    US
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    Telephone            |    617-254-3800
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    Fax                  |    617-779-1119
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Provider Business Mailing Address
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    Address Line         |    35 WOODCLIFF RD 
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    City                 |    NEWTON
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    State                |    MA
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    Zip                  |    02461-1822
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    Country              |    US
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    Telephone            |    617-965-2590
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    1877
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    License Number State |    MA
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