Provider Demographics
NPI:1073687414
Name:LANDA COMMUNICATIONS SERVICE
Entity Type:Organization
Organization Name:LANDA COMMUNICATIONS SERVICE
Other - Org Name:LANDA HEARING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:KUNG
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-406-1968
Mailing Address - Street 1:202 SHORE RD
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11363-1118
Mailing Address - Country:US
Mailing Address - Phone:718-353-5626
Mailing Address - Fax:718-353-0950
Practice Address - Street 1:139 CENTRE ST
Practice Address - Street 2:SUITE 803
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4408
Practice Address - Country:US
Practice Address - Phone:212-406-1968
Practice Address - Fax:212-431-1044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-19
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15000003650237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01690073Medicaid
NY=========OtherEIN