Provider Demographics
NPI:1881032712
Name:PHYSICIAN LANDING ZONE, P. C.
Entity Type:Organization
Organization Name:PHYSICIAN LANDING ZONE, P. C.
Other - Org Name:JENNIFER E. RUDIN, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDFARB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-578-7080
Mailing Address - Street 1:120 5TH AVE
Mailing Address - Street 2:MAIL DROP 2516
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-3000
Mailing Address - Country:US
Mailing Address - Phone:412-544-2039
Mailing Address - Fax:412-544-1147
Practice Address - Street 1:120 5TH AVE
Practice Address - Street 2:MAIL DROP 2516
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-3000
Practice Address - Country:US
Practice Address - Phone:412-544-2039
Practice Address - Fax:412-544-1147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD024240E207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1821128109OtherNPI
PA0009795000003Medicaid
PA1821128109OtherNPI