Provider Demographics
NPI:1316225238
Name:LANDO, JARED J (DPT)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:J
Last Name:LANDO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 PALMER AVE
Mailing Address - Street 2:APT 4A
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-4655
Mailing Address - Country:US
Mailing Address - Phone:914-450-7307
Mailing Address - Fax:
Practice Address - Street 1:2345 PALMER AVE
Practice Address - Street 2:APT 4A
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-4655
Practice Address - Country:US
Practice Address - Phone:914-450-7307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033919225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist