Healthcare Provider Details
I. General information
NPI: 1003429010
Provider Name (Legal Business Name): OPTIMAL THERAPY SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/28/2020
Last Update Date: 09/25/2020
Certification Date: 09/25/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
127 BEL AIR DRIVE
LONGMEADOW MA
01106
US
IV. Provider business mailing address
127 BEL AIR DRIVE
LONGMEADOW MA
01106
US
V. Phone/Fax
- Phone: 201-321-3757
- Fax:
- Phone: 201-321-3757
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0400X |
| Taxonomy | Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
MAHDIS
BIKHOF TORBATY
Title or Position: OCCUPATIONAL THERAPIST
Credential: MOT, OTR/L
Phone: 201-321-3757