Organization
SOVEREIGN MEDICAL SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN LANDOW MD (PRESIDENT)
(516) 277-2121
Entity
Organization
Contact information
Practice address
420 JERICHO TPKE, SUITE 212, JERICHO, NY 11753-1344
(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
Primary
176016
NY
Other
Enumeration date
07/09/2010
Last updated
07/09/2010
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