MEDICARE: HANDS TO FEET THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1265875306
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANDS TO FEET THERAPY LLC

Provider Business Mailing Address
First Line	:	1200 RIVER AVE
Second Line	:	BLDG. 10C
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-5657
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 RIVER AVE
Second Line	:	BLDG. 10C
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-5657
Country	:	US
Telephone Number	:	732-534-6707
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RENA LEDERER
Credential	:
Telephone Number	:	732-600-1128

Provider Enumeration Date	:	04/08/2013
Last Update Date	:	12/15/2014

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Directions to “HANDS TO FEET THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

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