Provider Demographics
NPI:1114501012
Name:TH REHAB OCCUPATIONAL THERAPY SERVICES, P.C.
Entity Type:Organization
Organization Name:TH REHAB OCCUPATIONAL THERAPY SERVICES, P.C.
Other - Org Name:TSR REHAB SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-803-2254
Mailing Address - Street 1:146 S COUNTRY RD STE 4
Mailing Address - Street 2:
Mailing Address - City:BELLPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11713-2530
Mailing Address - Country:US
Mailing Address - Phone:631-803-2254
Mailing Address - Fax:631-803-2254
Practice Address - Street 1:146 S COUNTRY RD STE 4
Practice Address - Street 2:
Practice Address - City:BELLPORT
Practice Address - State:NY
Practice Address - Zip Code:11713-2530
Practice Address - Country:US
Practice Address - Phone:631-803-2254
Practice Address - Fax:631-803-2254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-07
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical RehabilitationGroup - Multi-Specialty