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General NPI Number Information
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NPI Number | 1023258431
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Entity Type | Organization
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Legal Business Name | HOMESIDE REHAB, PT, OT, SLP LLC
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Dates
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Enumeration Date | 02/25/2009
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 441 ROUTE 306 STE 2
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City | MONSEY
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State | NY
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Zip | 10952-1234
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Country | US
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Telephone | 718-377-5000
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Fax | 718-377-5002
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Provider Business Mailing Address
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Address Line | 296 ROUTE 59 STE 12-25
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City | AIRMONT
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State | NY
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Zip | 10901-5322
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Country | US
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Telephone | 718-377-5000
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Fax | 718-377-5002
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. YISROEL BRODY
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Credential | DPT
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Telephone | 917-754-6634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number | 016301
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 016813
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 030125
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License Number State | NY
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