Provider Demographics
NPI:1396176178
Name:LANDA, LAUREN
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:LANDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1071 E 36TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4825
Mailing Address - Country:US
Mailing Address - Phone:845-821-1683
Mailing Address - Fax:
Practice Address - Street 1:1071 E 36TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-4825
Practice Address - Country:US
Practice Address - Phone:845-821-1683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-04
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker