Provider Demographics
NPI:1033474937
Name:HOME THERAPY PT PHYSICAL AND OCCUPATIONAL THERAPY LLC
Entity Type:Organization
Organization Name:HOME THERAPY PT PHYSICAL AND OCCUPATIONAL THERAPY LLC
Other - Org Name:HOME THERAPY PT LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOLSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, GCS
Authorized Official - Phone:973-393-5545
Mailing Address - Street 1:710 MILL ST
Mailing Address - Street 2:H3
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-5318
Mailing Address - Country:US
Mailing Address - Phone:914-509-5727
Mailing Address - Fax:914-623-0481
Practice Address - Street 1:799 MORRIS PARK AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-3604
Practice Address - Country:US
Practice Address - Phone:914-509-5727
Practice Address - Fax:914-623-0481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-08
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0195102251G0304X
NY018328225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty