| Land Medical, Inc. | |
|
4 Neshaminy Interplex Dr Ste 101 Feasterville Trevose PA 19053-6940 | |
| (215) 294-6790 | |
| Not Available |
| Full Name | Land Medical, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4 Neshaminy Interplex Dr Ste 101, Feasterville Trevose, Pennsylvania |
| Authorized Official Name and Position | Henry I Balogun (CHAIRMAN/CEO) |
| Authorized Official Contact | 2679930256 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Land Medical, Inc. 4 Neshaminy Interplex Dr Ste 101 Feasterville Trevose PA 19053-6940 Ph: (215) 294-6790 | Land Medical, Inc. 4 Neshaminy Interplex Dr Ste 101 Feasterville Trevose PA 19053-6940 Ph: (215) 294-6790 |
| NPI Number | 1568559714 |
|---|---|
| Provider Enumeration Date | 10/09/2006 |
| Last Update Date | 07/09/2025 |
| Medicare PECOS PAC ID | 5890606685 |
|---|---|
| Medicare Enrollment ID | O20050322000361 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568559714 | NPI | - | NPPES |
| 0018467050006 | Medicaid | PA |
| Provider Name | Nyok - Kheng Lim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952322356 PECOS PAC ID: 6204737950 Enrollment ID: I20040116000150 |
| Provider Name | Olutope Fakiyesi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407879109 PECOS PAC ID: 5294784484 Enrollment ID: I20050114000113 |
| Provider Name | Richard B Cornfield |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073602595 PECOS PAC ID: 6709832793 Enrollment ID: I20050323000316 |
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