Provider Demographics
NPI:1811062110
Name:LANDESBERG, STUART N (DC)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:N
Last Name:LANDESBERG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 ALBANY POST RD
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:NY
Mailing Address - Zip Code:10548-1447
Mailing Address - Country:US
Mailing Address - Phone:914-734-9500
Mailing Address - Fax:914-734-9309
Practice Address - Street 1:2125 ALBANY POST RD
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:NY
Practice Address - Zip Code:10548-1447
Practice Address - Country:US
Practice Address - Phone:914-734-9500
Practice Address - Fax:914-734-9309
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005183111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
X28161Medicare UPIN
X28163Medicare UPIN