Provider Demographics
NPI:1063446862
Name:LANDAY, NANCY C (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:C
Last Name:LANDAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ANDOVER SURGICAL ASSOC
Mailing Address - Street 2:140 HAVERHILL STREET
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810
Mailing Address - Country:US
Mailing Address - Phone:978-475-4202
Mailing Address - Fax:
Practice Address - Street 1:ANDOVER SURGICAL ASSOC.
Practice Address - Street 2:140 HAVERHILL STREET
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810
Practice Address - Country:US
Practice Address - Phone:978-475-4202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA77747208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
J30477Medicare Oscar/Certification