Provider Demographics
NPI:1407119191
Name:LANDAU, DAPHNE (MD)
Entity Type:Individual
Prefix:
First Name:DAPHNE
Middle Name:
Last Name:LANDAU
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 1:3400 SPRUCE STREET
Mailing Address - Street 2:2 SILVERSTEIN BUILDING
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4238
Mailing Address - Country:US
Mailing Address - Phone:215-662-2982
Mailing Address - Fax:215-662-7400
Practice Address - Street 1:3400 SPRUCE STREET
Practice Address - Street 2:2 SILVERSTEIN BUILDING
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4238
Practice Address - Country:US
Practice Address - Phone:215-662-2982
Practice Address - Fax:215-662-7400
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2023-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD480849207VM0101X
OH35129270207VM0101X
MA279149207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine