Provider Demographics
NPI:1720131915
Name:HOME THERAPY ADVANTAGE LLC
Entity Type:Organization
Organization Name:HOME THERAPY ADVANTAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GABBAY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:732-216-7859
Mailing Address - Street 1:289 US HIGHWAY 9
Mailing Address - Street 2:SUITE 73
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-8254
Mailing Address - Country:US
Mailing Address - Phone:732-216-7859
Mailing Address - Fax:
Practice Address - Street 1:289 US HIGHWAY 9
Practice Address - Street 2:SUITE 73
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-8254
Practice Address - Country:US
Practice Address - Phone:732-216-7859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ099385Medicare ID - Type Unspecified