Basic Information
| Provider Information | |||||||||
| NPI: | 1770733008 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LANDEN | ||||||||
| FirstName: | ALEXANDRA | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 CAPITAL WAY STE 456 | ||||||||
| Address2: | |||||||||
| City: | PENNINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 085342521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095377300 | ||||||||
| FaxNumber: | 6095377301 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 CAPITAL WAY STE 456 | ||||||||
| Address2: | |||||||||
| City: | PENNINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 085342521 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095377300 | ||||||||
| FaxNumber: | 6095377301 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2008 | ||||||||
| LastUpdateDate: | 11/01/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | OS016570 | PA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084N0400X | 149174 | DC | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 1028920260001 | 05 | PA | MEDICAID | 0277614 | 05 | NJ | MEDICAID |