| Organization Name: | HOMESIDE REHAB, PT, OT, SLP LLC |
| NPI Number: | 1023258431 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | YISROEL BRODY (DIRECTOR) |
| Mailing Address: | 3911 Avenue P Brooklyn |
| State: | NY US |
| Postal Code: | 112343501 |
| Phone Number: | 7183775000 |
| Fax Number: | 7183775002 |
| NPI Enumeration Date: | 02/25/2009 |
| NPI Last Update Date: | 06/12/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 016813 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |