Provider Demographics
NPI:1598178238
Name:LANDWIRT, CHAYA SARA (MSOT)
Entity Type:Individual
Prefix:MRS
First Name:CHAYA
Middle Name:SARA
Last Name:LANDWIRT
Suffix:
Gender:F
Credentials:MSOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 INDEPENDENCE CT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4158
Mailing Address - Country:US
Mailing Address - Phone:646-409-2308
Mailing Address - Fax:
Practice Address - Street 1:18 INDEPENDENCE CT
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4158
Practice Address - Country:US
Practice Address - Phone:646-409-2308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-10
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00646400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist