Provider Demographics
NPI:1265550941
Name:HODSON, MICHAELA M (PT)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:M
Last Name:HODSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MICHAELA
Other - Middle Name:M
Other - Last Name:BELLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1624 ANGELINA TER
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-5165
Mailing Address - Country:US
Mailing Address - Phone:518-248-0597
Mailing Address - Fax:
Practice Address - Street 1:100 SANDY DR
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-8191
Practice Address - Country:US
Practice Address - Phone:518-843-3503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17482225100000X
NY027082225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist