Organization
SOVEREIGN MEDICAL SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN S LANDOW M.D. (PRESIDENT)
(516) 277-2121
Entity
Organization
Contact information
Practice address
1050 5TH AVE, GROUND FLOOR, NEW YORK, NY 10028-0110
(516) 277-2121
(516) 277-2122
Mailing address
420 JERICHO TPKE, SUITE 212, JERICHO, NY 11753-1344
(516) 277-2121
(516) 277-2122
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
184141
NY
2086S0129X
Vascular Surgery Physician
Primary
217344
NY
Other
Enumeration date
05/05/2011
Last updated
05/05/2011
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