Healthcare Provider Details

I. General information

NPI: 1467450924
Provider Name (Legal Business Name): RENEE M HOFMAN RPH.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W KINGSBRIDGE RD
BRONX NY
10468-3903
US

IV. Provider business mailing address

7 WILLIAM PUCKEY DR
CORTLANDT MANOR NY
10567-6205
US

V. Phone/Fax

Practice location:
  • Phone: 718-410-1289
  • Fax: 718-410-1580
Mailing address:
  • Phone: 914-737-4164
  • Fax: 914-736-7121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number033344
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: