Provider Demographics
NPI:1386639391
Name:HOFFMEIER, CYNTHIA LEE (DO)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LEE
Last Name:HOFFMEIER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 WOOD ST
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:PA
Mailing Address - Zip Code:16214-1336
Mailing Address - Country:US
Mailing Address - Phone:814-226-7722
Mailing Address - Fax:814-227-2390
Practice Address - Street 1:420 WOOD ST
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:PA
Practice Address - Zip Code:16214-1336
Practice Address - Country:US
Practice Address - Phone:814-226-7722
Practice Address - Fax:814-227-2390
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-15
Last Update Date:2020-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS006389E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001132837003Medicaid
PAE06284Medicare UPIN
PA001132837003Medicaid