Provider Demographics
NPI:1104094416
Name:HOMITZ, LINDA SUNDAY (LPT)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:SUNDAY
Last Name:HOMITZ
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:MS
Other - First Name:L SUNDAY
Other - Middle Name:J
Other - Last Name:HOMITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPT
Mailing Address - Street 1:33790 BAINBRIDE RD.
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2947
Mailing Address - Country:US
Mailing Address - Phone:440-248-9255
Mailing Address - Fax:440-248-3608
Practice Address - Street 1:33200 BAINBRIDGE RD
Practice Address - Street 2:SUITE D
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2850
Practice Address - Country:US
Practice Address - Phone:440-248-9255
Practice Address - Fax:440-248-3608
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH004634225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4097011Medicare PIN