Provider Demographics
NPI:1518962158
Name:LANDAU, MARIAN GAIL (DO)
Entity Type:Individual
Prefix:DR
First Name:MARIAN
Middle Name:GAIL
Last Name:LANDAU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4516 BROWNS HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217
Mailing Address - Country:US
Mailing Address - Phone:412-422-7442
Mailing Address - Fax:412-904-5025
Practice Address - Street 1:127 ANDERSON ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-5803
Practice Address - Country:US
Practice Address - Phone:412-322-4151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-1234-03207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0000298Medicaid
PA1036750560003Medicaid
NM454591Medicaid
NM341402407OtherMEDICARE