MEDICARE: CHOMSKY THERAPY SERVICES 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	261QP2000X	Physical Therapy Clinic/Center
2	225100000X	Physical Therapist	PT21706	FL

General Provider Information

NPI Number	:	1568699247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHOMSKY THERAPY SERVICES INC.

Provider Business Mailing Address
First Line	:	6609 W WOOLBRIGHT RD STE 420
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-0917
Country	:	US
Telephone Number	:	561-200-4262
Fax Number	:	561-200-4268

Provider Business Practice Location Address
First Line	:	6609 W WOOLBRIGHT RD STE 420
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437
Country	:	US
Telephone Number	:	561-200-4262
Fax Number	:	561-200-4268

Authorized Official
Title or Position	:	PRESIDENT/SECRETARY
Name	:	MRS. CARYN LYNN CHOMSKY
Credential	:	DPT
Telephone Number	:	561-200-4262

Provider Enumeration Date	:	06/19/2009
Last Update Date	:	08/08/2018

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