Healthcare Provider Details

I. General information

NPI: 1598904203
Provider Name (Legal Business Name): ANNE MARIE HOFNAGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2009
Last Update Date: 02/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RAPP RD
ALBANY NY
12203-4491
US

IV. Provider business mailing address

1 RAPP RD
ALBANY NY
12203-4491
US

V. Phone/Fax

Practice location:
  • Phone: 518-867-3061
  • Fax: 518-867-3066
Mailing address:
  • Phone: 518-867-3061
  • Fax: 518-867-3066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number000595-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: