MEDICARE: DR. STUART N LANDESBERG DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	X005183	NY

General Provider Information

NPI Number	:	1811062110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STUART N LANDESBERG DC

Provider Business Mailing Address
First Line	:	2125 ALBANY POST RD
Second Line	:
City	:	MONTROSE
State	:	NY
Zip	:	10548-1447
Country	:	US
Telephone Number	:	914-734-9500
Fax Number	:	914-734-9309

Provider Business Practice Location Address
First Line	:	2125 ALBANY POST RD
Second Line	:
City	:	MONTROSE
State	:	NY
Zip	:	10548-1447
Country	:	US
Telephone Number	:	914-734-9500
Fax Number	:	914-734-9309

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	07/27/2021

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