Provider Demographics
NPI:1417264938
Name:THE LANDI WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:THE LANDI WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:F
Authorized Official - Last Name:LANDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-356-4848
Mailing Address - Street 1:777 CHESTNUT RIDGE RD STE 102
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10977-6221
Mailing Address - Country:US
Mailing Address - Phone:845-356-4848
Mailing Address - Fax:845-352-5664
Practice Address - Street 1:777 CHESTNUT RIDGE RD STE 102
Practice Address - Street 2:
Practice Address - City:CHESTNUT RIDGE
Practice Address - State:NY
Practice Address - Zip Code:10977-6221
Practice Address - Country:US
Practice Address - Phone:845-356-4848
Practice Address - Fax:845-352-5664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX001769111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty