Healthcare Provider Details

I. General information

NPI: 1114755477
Provider Name (Legal Business Name): ELLIE HOHENSEE BSN, RN, CCRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 W 168TH ST
NEW YORK NY
10032-3917
US

IV. Provider business mailing address

560 W 168TH ST
NEW YORK NY
10032-3917
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-4318
  • Fax:
Mailing address:
  • Phone: 212-305-4318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number932653
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: