Provider Demographics
NPI:1538326822
Name:LANDUCCI, STEVEN P (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:P
Last Name:LANDUCCI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:6028 HAWTHORN DR
Mailing Address - Street 2:
Mailing Address - City:MOON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15108-9064
Mailing Address - Country:US
Mailing Address - Phone:724-344-9535
Mailing Address - Fax:330-337-9052
Practice Address - Street 1:2875 E STATE ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-9303
Practice Address - Country:US
Practice Address - Phone:330-337-9045
Practice Address - Fax:330-337-9052
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4994152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2613989Medicaid
OHU77153Medicare UPIN