Basic Information
Provider Information | |||||||||
NPI: | 1336205111 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | HOBSON | ||||||||
FirstName: | HELENA | ||||||||
MiddleName: | MAISA | ||||||||
NamePrefix: | MRS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | P.T. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 187 E MARKET ST | ||||||||
Address2: | SUITE 142 | ||||||||
City: | RHINEBECK | ||||||||
State: | NY | ||||||||
PostalCode: | 125721727 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8458763595 | ||||||||
FaxNumber: | 8458760465 | ||||||||
Practice Location | |||||||||
Address1: | 187 E MARKET ST | ||||||||
Address2: | SUITE 142 | ||||||||
City: | RHINEBECK | ||||||||
State: | NY | ||||||||
PostalCode: | 125721727 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8458763595 | ||||||||
FaxNumber: | 8458760465 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 12/28/2006 | ||||||||
LastUpdateDate: | 12/19/2011 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 013171-1 | NY | Y |   | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |   |
ID Information
ID | Type | State | Issuer | Description | Q3728 | 01 | NY | EMPIRE BC BS | OTHER | P1304740 | 01 | NY | OXFORD | OTHER | 10035711 | 01 | NY | CDPHP | OTHER | 1393300 | 01 | NY | UNITED HEALTH CARE | OTHER | 437640 | 01 | NY | MVP HEALTHCARE | OTHER | 809235 | 01 | NY | EMPIRE PLAN NYS EMPLOYEES MPN | OTHER |