Healthcare Provider Details

I. General information

NPI: 1184951725
Provider Name (Legal Business Name): MARIE A HOFMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2009
Last Update Date: 11/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 CAMBELL AVENUE
WEST HAVEN CT
06516
US

IV. Provider business mailing address

1340 OLD CLINTON RD UNIT 1
WESTBROOK CT
06498-1889
US

V. Phone/Fax

Practice location:
  • Phone: 203-932-5711
  • Fax:
Mailing address:
  • Phone: 402-981-7748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12997
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20446
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: