Provider Demographics
NPI:1730567587
Name:LANDE, MARGALY
Entity type:Individual
Prefix:
First Name:MARGALY
Middle Name:
Last Name:LANDE
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 1:881 DEAN ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-3203
Mailing Address - Country:US
Mailing Address - Phone:212-360-7828
Mailing Address - Fax:
Practice Address - Street 1:1900 2ND AVE
Practice Address - Street 2:FLOOR 9
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-7406
Practice Address - Country:US
Practice Address - Phone:212-360-7875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092080-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker