Provider Demographics
NPI:1639887201
Name:EPIC THERAPEUTIC SOLUTIONS LLC
Entity Type:Organization
Organization Name:EPIC THERAPEUTIC SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAKEYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-979-2331
Mailing Address - Street 1:346 DUVIER PL
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07607-1111
Mailing Address - Country:US
Mailing Address - Phone:973-979-2331
Mailing Address - Fax:
Practice Address - Street 1:240 W PASSAIC ST STE 3
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07607-1264
Practice Address - Country:US
Practice Address - Phone:201-375-8290
Practice Address - Fax:551-209-2520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty