Healthcare Provider Details

I. General information

NPI: 1023795978
Provider Name (Legal Business Name): ELLA RAE MAIERHOFER RN, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 1ST AVE
NEW YORK NY
10016-9196
US

IV. Provider business mailing address

106 MADISON ST APT 4A
NEW YORK NY
10002-7296
US

V. Phone/Fax

Practice location:
  • Phone: 212-562-4141
  • Fax:
Mailing address:
  • Phone: 206-681-6875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number433092
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number433092
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: