MEDICARE: PHYSICIAN LANDING ZONE, P.C.

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	208VP0000X	Pain Medicine Physician	MD040157L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1386613131	OTHER		NPI

General Provider Information

NPI Number	:	1285072405
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIAN LANDING ZONE, P.C.

Provider Business Mailing Address
First Line	:	3402 WASHINGTON RD
Second Line	:
City	:	MC MURRAY
State	:	PA
Zip	:	15317-2964
Country	:	US
Telephone Number	:	724-942-5188
Fax Number	:

Provider Business Practice Location Address
First Line	:	3402 WASHINGTON RD
Second Line	:
City	:	MC MURRAY
State	:	PA
Zip	:	15317-2964
Country	:	US
Telephone Number	:	724-942-5188
Fax Number	:	724-942-5878

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. WILLIAM GOLDFARB
Credential	:	MD
Telephone Number	:	412-578-7080

Provider Enumeration Date	:	06/10/2013
Last Update Date	:	06/10/2013

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