Provider Demographics
NPI:1760639280
Name:HOFFER, ELLEN BROSOFSKY (NP)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:BROSOFSKY
Last Name:HOFFER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:R
Other - Last Name:BROSOFSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:455 TOLLGATE RD
Mailing Address - Street 2:PROFESSIONAL REVENUE CYCLE & CREDENTIALING
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2759
Mailing Address - Country:US
Mailing Address - Phone:401-273-0641
Mailing Address - Fax:401-273-2919
Practice Address - Street 1:455 TOLL GATE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2759
Practice Address - Country:US
Practice Address - Phone:401-681-4996
Practice Address - Fax:401-921-6569
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN00217363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI050378071OtherTIN