Provider Demographics
NPI:1407034945
Name:LANDMANN, DAN SIMON (MD)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:SIMON
Last Name:LANDMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 GRAND AVE
Mailing Address - Street 2:SUITE 137
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661
Mailing Address - Country:US
Mailing Address - Phone:201-696-2646
Mailing Address - Fax:201-485-6570
Practice Address - Street 1:63 GRAND AVE
Practice Address - Street 2:SUITE 137
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661
Practice Address - Country:US
Practice Address - Phone:201-696-2646
Practice Address - Fax:201-485-6570
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT048413207W00000X
NJ25MA09380100207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology