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NPI Code Detail

MEDICARE: GERTRUDE M MAES P.T.

MEDICARE:   GERTRUDE M MAES  P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2738NM

General Provider Information

NPI Number : 1255503546
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERTRUDE M MAES P.T.
Provider Business Mailing Address
First Line : 2118 CENTRAL AVE SE
Second Line : #115
City : ALBUQUERQUE
State : NM
Zip : 87106-4004
Country : US
Telephone Number : 661-805-2992
Fax Number :
Provider Business Practice Location Address
First Line : 13609 CALIFORNIA ST
Second Line :
City : OMAHA
State : NE
Zip : 68154-5260
Country : US
Telephone Number : 800-456-5857
Fax Number : 402-895-7812
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2008
Last Update Date : 03/27/2008

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Directions to “ GERTRUDE M MAES P.T.” Practice Location

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