Healthcare Provider Details

I. General information

NPI: 1780107342
Provider Name (Legal Business Name): IN HOME PHYSICAL THERAPY OF BOSTON PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 HEATH ST
CHESTNUT HILL MA
02467-2351
US

IV. Provider business mailing address

3801 N 40TH AVE
HOLLYWOOD FL
33021-1860
US

V. Phone/Fax

Practice location:
  • Phone: 347-947-3132
  • Fax: 947-438-2942
Mailing address:
  • Phone: 617-209-3066
  • Fax: 617-209-6037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUSAN LOBERFELD
Title or Position: PARTNER
Credential:
Phone: 617-209-3306