Provider Demographics
NPI:1225370414
Name:LANDAU-WEST, DEBRA (MS,RD)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:
Last Name:LANDAU-WEST
Suffix:
Gender:F
Credentials:MS,RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18779 N 91ST PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-5365
Mailing Address - Country:US
Mailing Address - Phone:480-502-1633
Mailing Address - Fax:
Practice Address - Street 1:18779 N 91ST PL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-5365
Practice Address - Country:US
Practice Address - Phone:480-502-1633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z68622Medicare PIN