Doctor Name: | LISA M LANDIS |
NPI Number: | 1851472765 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | MA052788 |
Business Practice Address: | 3175 Cape Horn Rd Red Lion, PA - 173568806 |
Business Phone Number: | 8885205060 |
Business Fax Number: | 7178123950 |
Mailing Address: | 1803 Mount Rose Ave, YORK |
State: | PA |
Postal Code: | 174033026 |
Phone Number: | 7178511405 |
Fax Number: | 7178123950 |
NPI Enumeration Date: | 10/18/2006 |
NPI Last Update Date: | 08/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | MA052788 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |