Provider Demographics
NPI:1972572527
Name:LANDFAIR, ROY J (MD)
Entity type:Individual
Prefix:DR
First Name:ROY
Middle Name:J
Last Name:LANDFAIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 LOCUST ST
Mailing Address - Street 2:STE. 1070
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-5136
Mailing Address - Country:US
Mailing Address - Phone:412-359-6550
Mailing Address - Fax:412-235-9649
Practice Address - Street 1:1501 LOCUST ST
Practice Address - Street 2:STE. 1070
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5136
Practice Address - Country:US
Practice Address - Phone:412-359-6550
Practice Address - Fax:412-235-9649
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD015180E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000711263Medicaid
PA0007112630001Medicaid
PA600678JULMedicare ID - Type UnspecifiedGROUP
PA102454QJDMedicare PIN
PAB36470Medicare UPIN
PA102454JULMedicare PIN