Provider Demographics
NPI:1831343433
Name:HOSPEDALES, AMADIKA BIENTA (MSPT)
Entity type:Individual
Prefix:MISS
First Name:AMADIKA
Middle Name:BIENTA
Last Name:HOSPEDALES
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 WARWICK AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10553-1814
Mailing Address - Country:US
Mailing Address - Phone:917-642-5169
Mailing Address - Fax:
Practice Address - Street 1:350 WARWICK AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10553-1814
Practice Address - Country:US
Practice Address - Phone:917-642-5169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPT024372225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist