MEDICARE: DR. HOWARD S LANDSMAN D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	25MB07707000	NJ

General Provider Information

NPI Number	:	1245227826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD S LANDSMAN D.O.

Provider Business Mailing Address
First Line	:	1608 ROUTE 88
Second Line	:	SUITE 240
City	:	BRICK
State	:	NJ
Zip	:	08724-3009
Country	:	US
Telephone Number	:	732-458-8575
Fax Number	:	732-206-0578

Provider Business Practice Location Address
First Line	:	1608 ROUTE 88
Second Line	:	SUITE 240
City	:	BRICK
State	:	NJ
Zip	:	08724-3009
Country	:	US
Telephone Number	:	732-458-8575
Fax Number	:	732-206-0578

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	03/10/2014

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