Provider Demographics
NPI:1558376327
Name:LANDT, KYLE WINTER (MD)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:WINTER
Last Name:LANDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WASHINGTON PL
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6736
Mailing Address - Country:US
Mailing Address - Phone:603-695-2500
Mailing Address - Fax:603-629-1785
Practice Address - Street 1:5 WASHINGTON PL
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6736
Practice Address - Country:US
Practice Address - Phone:603-695-2500
Practice Address - Fax:603-629-1785
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH75242080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3001805Medicaid
NHNH9254Medicare PIN
NHB86187Medicare UPIN