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NPI Code Detail

MEDICARE: HOME THERAPY PT PHYSICAL AND OCCUPATIONAL THERAPY LLC

MEDICARE: HOME THERAPY PT PHYSICAL AND OCCUPATIONAL 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
12251G0304XGeriatric Physical Therapist019510NY

General Provider Information

NPI Number : 1275884348
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOME THERAPY PT PHYSICAL AND OCCUPATIONAL THERAPY LLC
Provider Business Mailing Address
First Line : 710 MILL ST
Second Line : UNIT H3
City : BELLEVILLE
State : NJ
Zip : 07109-5318
Country : US
Telephone Number : 973-759-1494
Fax Number : 973-759-0557
Provider Business Practice Location Address
First Line : 817 E 180TH ST
Second Line :
City : BRONX
State : NY
Zip : 10460-1305
Country : US
Telephone Number : 718-355-9652
Fax Number : 718-355-9652
Authorized Official
Title or Position : MANAGING DIRECTOR
Name : DR. RICHARD HOLSMAN
Credential : PT, DPT, MAT, GCS
Telephone Number : 973-393-5545
Provider Enumeration Date : 09/28/2012
Last Update Date : 08/24/2021

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Directions to “HOME THERAPY PT PHYSICAL AND OCCUPATIONAL THERAPY LLC ” Practice Location

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