MEDICARE: HOME PHYSICAL THERAPY AND WELLNESS, P.C.

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	019821	NY

General Provider Information

NPI Number	:	1457342552
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME PHYSICAL THERAPY AND WELLNESS, P.C.

Provider Business Mailing Address
First Line	:	54 WASHINGTON ST
Second Line	:	NASSAU COUNTY
City	:	FARMINGDALE
State	:	NY
Zip	:	11735-2639
Country	:	US
Telephone Number	:	516-694-4426
Fax Number	:	516-694-4426

Provider Business Practice Location Address
First Line	:	54 WASHINGTON ST
Second Line	:	NASSAU COUNTY
City	:	FARMINGDALE
State	:	NY
Zip	:	11735-2639
Country	:	US
Telephone Number	:	516-694-4426
Fax Number	:	516-694-4426

Authorized Official
Title or Position	:	PHYSICAL THERAPIST/OWNER
Name	:	MS. JANA LORI HERR
Credential	:	P.T.
Telephone Number	:	516-694-4426

Provider Enumeration Date	:	10/30/2005
Last Update Date	:	10/10/2007

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Directions to “HOME PHYSICAL THERAPY AND WELLNESS, P.C. ” Practice Location

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