MEDICARE: HUDSON IN HOME PHYSICAL THERAPY AND OCCUPATIONAL THERAPY PLLC

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	225100000X	Physical Therapist
2	225XP0019X	Physical Rehabilitation Occupational Therapist

General Provider Information

NPI Number	:	1366197758
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUDSON IN HOME PHYSICAL THERAPY AND OCCUPATIONAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	3801 N 40TH AVE
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-1860
Country	:	US
Telephone Number	:	347-947-3132
Fax Number	:	347-438-2942

Provider Business Practice Location Address
First Line	:	1 BLACKSTONE PL
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10471-3607
Country	:	US
Telephone Number	:	347-947-3132
Fax Number	:	347-438-2942

Authorized Official
Title or Position	:	OWNER
Name	:	SUSAN LOBERFELD
Credential	:	PT
Telephone Number	:	347-947-3132

Provider Enumeration Date	:	02/15/2022
Last Update Date	:	03/08/2022

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