MEDICARE: IN HOME PHYSICAL THERAPY OF BOSTON PLLC

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

General Provider Information

NPI Number	:	1780107342
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN HOME PHYSICAL THERAPY OF BOSTON PLLC

Provider Business Mailing Address
First Line	:	3801 N 40TH AVE
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-1860
Country	:	US
Telephone Number	:	617-209-3066
Fax Number	:	617-209-6037

Provider Business Practice Location Address
First Line	:	501 HEATH ST
Second Line	:
City	:	CHESTNUT HILL
State	:	MA
Zip	:	02467-2351
Country	:	US
Telephone Number	:	347-947-3132
Fax Number	:	947-438-2942

Authorized Official
Title or Position	:	PARTNER
Name	:	SUSAN LOBERFELD
Credential	:
Telephone Number	:	617-209-3306

Provider Enumeration Date	:	07/25/2017
Last Update Date	:	07/21/2022

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