MEDICARE: TELETHERAPEUTICS HEALTH INCORPORATED

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	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1336885284
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TELETHERAPEUTICS HEALTH INCORPORATED

Provider Business Mailing Address
First Line	:	79 OGLE RD
Second Line	:
City	:	OLD TAPPAN
State	:	NJ
Zip	:	07675-7026
Country	:	US
Telephone Number	:	732-485-1301
Fax Number	:	302-469-2115

Provider Business Practice Location Address
First Line	:	774 E 2100 S
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84106-1863
Country	:	US
Telephone Number	:	888-420-0589
Fax Number	:	201-646-3955

Authorized Official
Title or Position	:	OWNER
Name	:	YASIR J. AHMAD
Credential	:	MD
Telephone Number	:	781-373-8199

Provider Enumeration Date	:	05/12/2022
Last Update Date	:	05/13/2025

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Directions to “TELETHERAPEUTICS HEALTH INCORPORATED ” Practice Location

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