Provider Demographics
NPI:1528215498
Name:HOFSTETTER, ANNIKA M (MD, PHD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ANNIKA
Middle Name:M
Last Name:HOFSTETTER
Suffix:
Gender:F
Credentials:MD, PHD, MPH
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:622 W 168TH ST
Mailing Address - Street 2:VC402
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:622 W 168TH ST
Practice Address - Street 2:VC402
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-6627
Practice Address - Fax:212-305-8819
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY247955208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY247955OtherNEW YORK STATE MEDICAL LICENSE