Provider Demographics
NPI:1568528917
Name:HOFFMAN, DEBRA ELLEN (RD CDE)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ELLEN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:RD CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 JORDAN RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4466
Mailing Address - Country:US
Mailing Address - Phone:716-632-0529
Mailing Address - Fax:716-298-2054
Practice Address - Street 1:142 JORDAN RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-4466
Practice Address - Country:US
Practice Address - Phone:716-946-0119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1546-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY15461OtherCDN
NY09213213OtherCERTIFIED DIABETES EDUCAT
NYP71640Medicare UPIN