Healthcare Provider Details

I. General information

NPI: 1871815258
Provider Name (Legal Business Name): AMY MARIE HOAG RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2010
Last Update Date: 02/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 N BEDFORD RD
MOUNT KISCO NY
10549-1143
US

IV. Provider business mailing address

411 WALNUT ST # 8022
GREEN COVE SPRINGS FL
32043-3443
US

V. Phone/Fax

Practice location:
  • Phone: 914-241-1260
  • Fax:
Mailing address:
  • Phone: 914-393-1059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number043146-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: