Healthcare Provider Details
I. General information
NPI: 1992270516
Provider Name (Legal Business Name): LILY HOFFMAN-ANDREWS MS, LCGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/10/2018
Last Update Date: 10/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3400 CIVIC CENTER BLVD
PHILADELPHIA PA
19104-5127
US
IV. Provider business mailing address
3400 CIVIC CENTER BLVD
PHILADELPHIA PA
19104-5127
US
V. Phone/Fax
- Phone: 215-615-1263
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 170300000X |
| Taxonomy | Genetic Counselor (M.S.) |
| License Number | GC000475 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: