Provider Demographics
NPI:1629600143
Name:MT. VERNON SPINE AND JOINT MEDICINE PC
Entity Type:Organization
Organization Name:MT. VERNON SPINE AND JOINT MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LANDIS
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:914-699-6763
Mailing Address - Street 1:704 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:MT. VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-2111
Mailing Address - Country:US
Mailing Address - Phone:914-699-6763
Mailing Address - Fax:914-699-0070
Practice Address - Street 1:704 LOCUST ST
Practice Address - Street 2:
Practice Address - City:MT. VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552-2111
Practice Address - Country:US
Practice Address - Phone:914-699-6763
Practice Address - Fax:914-699-0070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty