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General NPI Number Information
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NPI Number | 1023822244
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Entity Type | Organization
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Legal Business Name | HERSTEL THERAPIE INC
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 191 BRADLEY AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10314-5166
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Country | US
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Telephone | 718-698-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 48 RESERVOIR RD
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City | HACKETTSTOWN
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State | NJ
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Zip | 07840-5647
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Country | US
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Telephone | 718-909-4660
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EBENEZER A AWOLESI
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Credential |
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Telephone | 718-909-4660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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