Provider Demographics
NPI:1427521665
Name:LANDA VISION, INC.
Entity type:Organization
Organization Name:LANDA VISION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-602-3295
Mailing Address - Street 1:10983 VINEYARD DR
Mailing Address - Street 2:
Mailing Address - City:NORTH EAST
Mailing Address - State:PA
Mailing Address - Zip Code:16428-6619
Mailing Address - Country:US
Mailing Address - Phone:724-602-3295
Mailing Address - Fax:
Practice Address - Street 1:5158 PEACH ST UNIT 20B
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-2489
Practice Address - Country:US
Practice Address - Phone:814-520-5743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty