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General NPI Number Information
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NPI Number | 1841307956
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Entity Type | Individual
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Provider Name | DANIELLE M LANDZINSKI PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 06/18/2020
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Provider Practice Location Address
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Address Line | 10615 JUDICIAL DR STE 401
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City | FAIRFAX
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State | VA
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Zip | 22030-7501
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Country | US
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Telephone | 571-295-6602
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Fax |
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Provider Business Mailing Address
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Address Line | 5004 PHEASANT RIDGE RD
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City | FAIRFAX
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State | VA
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Zip | 22030-6215
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Country | US
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Telephone | 703-895-2310
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA030493
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0110002311
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License Number State | VA
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