Healthcare Provider Details

I. General information

NPI: 1013952530
Provider Name (Legal Business Name): HAROLD J HOFFMEIER JR. P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 06/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 S PORTER ST
WATKINS GLEN NY
14891-1622
US

IV. Provider business mailing address

571 SAINT JOSEPHS BLVD FL 2
ELMIRA NY
14901-3230
US

V. Phone/Fax

Practice location:
  • Phone: 607-535-7873
  • Fax: 607-535-7469
Mailing address:
  • Phone: 607-271-2050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number000251-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: