Provider Demographics
NPI:1245392331
Name:LANDMAN, KRISTIN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:
Last Name:LANDMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 MONROE ROAD
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066
Mailing Address - Country:US
Mailing Address - Phone:914-420-3785
Mailing Address - Fax:
Practice Address - Street 1:7600 CENTRAL AVENUE
Practice Address - Street 2:JEANES HOSPITAL-DEPARTMENT OF PREADMISSION TESTING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111
Practice Address - Country:US
Practice Address - Phone:215-728-2338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010280363A00000X
PAMA053949363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant