Provider Demographics
NPI:1306388590
Name:HOSMER, ELAINE LISA BAMFORD (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:LISA BAMFORD
Last Name:HOSMER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 BUCKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2138
Mailing Address - Country:US
Mailing Address - Phone:585-270-4840
Mailing Address - Fax:
Practice Address - Street 1:27 LACKAWANNA AVE
Practice Address - Street 2:
Practice Address - City:MOUNT MORRIS
Practice Address - State:NY
Practice Address - Zip Code:14510-1001
Practice Address - Country:US
Practice Address - Phone:585-658-7811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-06
Last Update Date:2016-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0566521041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool