MEDICARE: ANGELIKA HOFMEISTER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	013237-1	NY
2	363AS0400X	Surgical Physician Assistant	13237	NY
3	363AM0700X	Medical Physician Assistant	PA423	KY

General Provider Information

NPI Number	:	1689761967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELIKA HOFMEISTER PA-C

Provider Business Mailing Address
First Line	:	601 ELMWOOD AVENUE BOX 665
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14642-4136
Country	:	US
Telephone Number	:	585-275-5321
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 ELMWOOD AVENUE BOX 665
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14642-4136
Country	:	US
Telephone Number	:	585-275-5321
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	05/15/2023

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