Provider Demographics
NPI:1386841344
Name:HAMOY, LIZA MAY (PT)
Entity Type:Individual
Prefix:MRS
First Name:LIZA
Middle Name:MAY
Last Name:HAMOY
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 1:227 CHISHOLM PL
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-6572
Mailing Address - Country:US
Mailing Address - Phone:260-490-4509
Mailing Address - Fax:
Practice Address - Street 1:227 CHISHOLM PL
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-6572
Practice Address - Country:US
Practice Address - Phone:260-490-4509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05007128A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1555-656Medicaid