MEDICARE: DR. REBECCA HAN LANDOLFI O.D.

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	152W00000X	Optometrist	27OA00653400	NJ

General Provider Information

NPI Number	:	1841606290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBECCA HAN LANDOLFI O.D.

Provider Business Mailing Address
First Line	:	3495 ROUTE 1 S
Second Line	:
City	:	PRINCETON
State	:	NJ
Zip	:	08540-5933
Country	:	US
Telephone Number	:	609-919-1001
Fax Number	:

Provider Business Practice Location Address
First Line	:	3495 US HIGHWAY 1
Second Line	:
City	:	PRINCETON
State	:	NJ
Zip	:	08540-5933
Country	:	US
Telephone Number	:	609-919-1001
Fax Number	:

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

Provider Enumeration Date	:	07/07/2014
Last Update Date	:	11/08/2020

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