Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 25MA08909300 | NJ |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 25MA08909300 | NJ |
NPI | 1366647331 |
---|---|
Provider Name | Joshua Landa |
First Address | Englewood, NJ 07631-1944 |
Second Address | Englewood, NJ 07631-1944 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 26/02/2014 |