MEDICARE: ATHOME THERAPY SOLUTIONS-EAST WEST, LLC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1477254266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATHOME THERAPY SOLUTIONS-EAST WEST, LLC

Provider Business Mailing Address
First Line	:	493 WALNUT ST
Second Line	:
City	:	RIDGEFIELD
State	:	NJ
Zip	:	07657-2601
Country	:	US
Telephone Number	:	201-280-3738
Fax Number	:	201-840-9683

Provider Business Practice Location Address
First Line	:	493 WALNUT ST
Second Line	:
City	:	RIDGEFIELD
State	:	NJ
Zip	:	07657-2601
Country	:	US
Telephone Number	:	201-280-3738
Fax Number	:	201-840-9683

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MARIA LYNN YASAY
Credential	:	PT
Telephone Number	:	201-280-3738

Provider Enumeration Date	:	03/17/2023
Last Update Date	:	03/17/2023

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