Provider Demographics
NPI:1396096798
Name:PRIME HOME THERAPY, LLP
Entity type:Organization
Organization Name:PRIME HOME THERAPY, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHLOMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:RIND
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:646-204-0354
Mailing Address - Street 1:10460 QUEENS BLVD APT 11C
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-7324
Mailing Address - Country:US
Mailing Address - Phone:646-204-0354
Mailing Address - Fax:
Practice Address - Street 1:12012 COLDSTREAM DR
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-3619
Practice Address - Country:US
Practice Address - Phone:646-204-0354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty