Provider Demographics
NPI:1356973259
Name:HOCKADAY, ADAM
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:HOCKADAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 IROQUOIS ST APT 31
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02120-2841
Mailing Address - Country:US
Mailing Address - Phone:919-795-5337
Mailing Address - Fax:
Practice Address - Street 1:4 MEDICAL PARK DR STE B
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3572
Practice Address - Country:US
Practice Address - Phone:845-625-2816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-08
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA24277225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist