Provider Demographics
NPI:1184052763
Name:LAND SEA AND AIR
Entity type:Organization
Organization Name:LAND SEA AND AIR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:D
Authorized Official - Last Name:PANZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-991-3236
Mailing Address - Street 1:15 VICTORIA RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-1406
Mailing Address - Country:US
Mailing Address - Phone:631-487-5368
Mailing Address - Fax:
Practice Address - Street 1:15 VICTORIA RD
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-1406
Practice Address - Country:US
Practice Address - Phone:631-487-5368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016689261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care