Organization Name: | LANDMARK HEALTH NY IPA |
NPI Number: | 1144620980 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL HUY LE (CHIEF MEDICAL OFFICER) |
Mailing Address: | 701 Seneca St Suite 416 Buffalo |
State: | NY US |
Postal Code: | 142101351 |
Phone Number: | 8669484720 |
Fax Number: | |
NPI Enumeration Date: | 08/29/2014 |
NPI Last Update Date: | 08/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 275960 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |