Healthcare Provider Details

I. General information

NPI: 1629064142
Provider Name (Legal Business Name): ELIZABETH HOFFMEIER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 01/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 N AURORA ST
ITHACA NY
14850-4345
US

IV. Provider business mailing address

217 N AURORA ST
ITHACA NY
14850-4345
US

V. Phone/Fax

Practice location:
  • Phone: 607-273-2811
  • Fax: 607-273-1170
Mailing address:
  • Phone: 607-273-2811
  • Fax: 607-273-1170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF3322811
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: