Provider Demographics
NPI:1841606290
Name:LANDOLFI, REBECCA HAN (OD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:HAN
Last Name:LANDOLFI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:HAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3495 ROUTE 1 S
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-5933
Mailing Address - Country:US
Mailing Address - Phone:609-919-1001
Mailing Address - Fax:
Practice Address - Street 1:3495 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-5933
Practice Address - Country:US
Practice Address - Phone:609-919-1001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2020-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00653400152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist