MEDICARE: EB OT 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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1922967785
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EB OT LLC

Provider Business Mailing Address
First Line	:	5622 FALCON DR
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18017-8216
Country	:	US
Telephone Number	:	917-576-4399
Fax Number	:

Provider Business Practice Location Address
First Line	:	465 CRANBURY RD STE 102
Second Line	:
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-7600
Country	:	US
Telephone Number	:	908-202-3060
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MAHVISH GILANI
Credential	:	BCBA, LBA
Telephone Number	:	917-576-4399

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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