Provider Demographics
NPI:1376627190
Name:LANDAU, ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:
Last Name:LANDAU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 MEDICAL PARK DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3562
Mailing Address - Country:US
Mailing Address - Phone:845-638-4464
Mailing Address - Fax:845-638-4509
Practice Address - Street 1:7 MEDICAL PARK DR
Practice Address - Street 2:SUITE B
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3562
Practice Address - Country:US
Practice Address - Phone:845-638-4464
Practice Address - Fax:845-638-4509
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133917207R00000X
NJMA38869207R00000X
FLME54639207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C06110Medicare UPIN