Healthcare Provider Details

I. General information

NPI: 1134132970
Provider Name (Legal Business Name): PATRICIA LEE HOFFARTH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 MAPLE RD
WILLIAMSVILLE NY
14221-2918
US

IV. Provider business mailing address

61 MAPLE RD
WILLIAMSVILLE NY
14221-2918
US

V. Phone/Fax

Practice location:
  • Phone: 716-565-1234
  • Fax: 716-565-1246
Mailing address:
  • Phone: 716-565-1234
  • Fax: 716-565-1246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF300322-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: