MEDICARE: JESSICA LANDAU LMSW

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	104100000X	Social Worker	128762	NY

General Provider Information

NPI Number	:	1902757933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA LANDAU LMSW

Provider Business Mailing Address
First Line	:	50 ROUTE 111 STE 101
Second Line	:
City	:	SMITHTOWN
State	:	NY
Zip	:	11787-3700
Country	:	US
Telephone Number	:	631-805-5668
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 ROUTE 111
Second Line	:
City	:	SMITHTOWN
State	:	NY
Zip	:	11787-3738
Country	:	US
Telephone Number	:	631-805-5668
Fax Number	:

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

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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Directions to “ JESSICA LANDAU LMSW” Practice Location

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