Healthcare Provider Details

I. General information

NPI: 1114927829
Provider Name (Legal Business Name): LORI HOBDAY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6221 RTE 31 STE 103
CICERO NY
13039
US

IV. Provider business mailing address

6221 RTE 31 STE 103
CICERO NY
13039
US

V. Phone/Fax

Practice location:
  • Phone: 315-699-1009
  • Fax: 315-699-1094
Mailing address:
  • Phone: 315-699-1009
  • Fax: 315-699-1094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number024307
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: