Provider Demographics
NPI:1124079124
Name:LANDSMAN, BRAD H (PHD)
Entity type:Individual
Prefix:DR
First Name:BRAD
Middle Name:H
Last Name:LANDSMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 LINDEN OAKS
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2840
Mailing Address - Country:US
Mailing Address - Phone:585-385-1950
Mailing Address - Fax:585-385-9315
Practice Address - Street 1:100 LINDEN OAKS
Practice Address - Street 2:SUITE 102
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2840
Practice Address - Country:US
Practice Address - Phone:585-385-1950
Practice Address - Fax:585-385-9315
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY09702103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist