Provider Demographics
NPI:1477787083
Name:LANDSBERG, JEFFREY N (PT)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:N
Last Name:LANDSBERG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11943
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07101-4943
Mailing Address - Country:US
Mailing Address - Phone:914-771-9666
Mailing Address - Fax:
Practice Address - Street 1:112 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:DANIA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33004-3623
Practice Address - Country:US
Practice Address - Phone:954-920-5050
Practice Address - Fax:954-920-7992
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009470-1174400000X
FLPT39832225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist