Provider Demographics
NPI:1295034916
Name:HASTINGS, GEORGIA ANNE (PT ASST)
Entity Type:Individual
Prefix:MRS
First Name:GEORGIA
Middle Name:ANNE
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:PT ASST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:ULSTER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12487-5417
Mailing Address - Country:US
Mailing Address - Phone:845-339-0014
Mailing Address - Fax:945-339-9601
Practice Address - Street 1:10 HOUSE LN
Practice Address - Street 2:
Practice Address - City:ULSTER PARK
Practice Address - State:NY
Practice Address - Zip Code:12487-5417
Practice Address - Country:US
Practice Address - Phone:845-339-0014
Practice Address - Fax:845-339-9601
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000725-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant