Provider Demographics
NPI:1376915389
Name:HANDS ON AT HOME PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:HANDS ON AT HOME PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DORIAN
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:NISSENSON
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:917-597-7031
Mailing Address - Street 1:7 BLACK BIRCH RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-2603
Mailing Address - Country:US
Mailing Address - Phone:917-597-7031
Mailing Address - Fax:
Practice Address - Street 1:7 BLACK BIRCH RD
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-2603
Practice Address - Country:US
Practice Address - Phone:917-597-7031
Practice Address - Fax:203-293-4173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-29
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT008793251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health