Provider Demographics
NPI:1730250960
Name:HOKSBERGEN, MARIA E (PT)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:E
Last Name:HOKSBERGEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 CORTE DEL POZO
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-6711
Mailing Address - Country:US
Mailing Address - Phone:505-660-7756
Mailing Address - Fax:
Practice Address - Street 1:1800 OLD PECOS TRL STE G
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4759
Practice Address - Country:US
Practice Address - Phone:505-954-9940
Practice Address - Fax:505-954-9946
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM41139771Medicaid