Provider Demographics
NPI:1184951725
Name:HOFMAN, MARIE A (PHARMD)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:A
Last Name:HOFMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 OLD CLINTON RD
Mailing Address - Street 2:UNIT 1
Mailing Address - City:WESTBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06498-1889
Mailing Address - Country:US
Mailing Address - Phone:402-981-7748
Mailing Address - Fax:
Practice Address - Street 1:950 CAMBELL AVENUE
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516
Practice Address - Country:US
Practice Address - Phone:203-932-5711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-03
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12997183500000X
IA20446183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist