Provider Demographics
NPI:1174366702
Name:LANDFAIR, TARONNICA V
Entity type:Individual
Prefix:
First Name:TARONNICA
Middle Name:V
Last Name:LANDFAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3281 E 147TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120-4131
Mailing Address - Country:US
Mailing Address - Phone:216-358-3484
Mailing Address - Fax:
Practice Address - Street 1:3281 E 147TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-4131
Practice Address - Country:US
Practice Address - Phone:216-358-3484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide