Individual
MRS. SANDRA KAE LANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6003 BIG TREE RD, LAKEVILLE, NY 14480-9753
(585) 346-2400
(585) 346-2413
Mailing address
2469 STATE ROUTE 19 N, WARSAW, NY 14569-9336
(585) 786-8505
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
006039-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417350463
—
NY
Enumeration date
04/12/2018
Last updated
04/12/2018
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