MEDICARE: TELETHERAPEUTICS HEALTH OH INC.

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	103T00000X	Psychologist

General Provider Information

NPI Number	:	1508526559
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TELETHERAPEUTICS HEALTH OH INC.

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	:

Provider Business Practice Location Address
First Line	:	6545 MARKET AVE N # 100
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44721-2430
Country	:	US
Telephone Number	:	888-420-0589
Fax Number	:	201-646-3955

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

Provider Enumeration Date	:	12/17/2021
Last Update Date	:	02/27/2026

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