Healthcare Provider Details

I. General information

NPI: 1285122846
Provider Name (Legal Business Name): DAVID LANDZBERG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2018
Last Update Date: 05/10/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 BERGEN ST
NEWARK NJ
07103
US

IV. Provider business mailing address

2 CYPRESS PEAK LN
MONTVALE NJ
07645-1204
US

V. Phone/Fax

Practice location:
  • Phone: 201-264-6447
  • Fax:
Mailing address:
  • Phone: 201-264-6447
  • Fax: 201-264-6447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD217129
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MA12205700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: