Provider Demographics
NPI:1578830659
Name:BISCHOFF, NIKI OSTROM
Entity Type:Individual
Prefix:MS
First Name:NIKI
Middle Name:OSTROM
Last Name:BISCHOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:NIKI
Other - Middle Name:OSTROM
Other - Last Name:BISCHOFF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-0070
Mailing Address - Country:US
Mailing Address - Phone:315-793-8500
Mailing Address - Fax:315-793-8540
Practice Address - Street 1:4747 MIDDLESETTLEMENT ROAD
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-0070
Practice Address - Country:US
Practice Address - Phone:315-793-8500
Practice Address - Fax:315-793-8540
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233028-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse