Provider Demographics
NPI:1154410835
Name:HOFFMAN, ELYSE JEANNETTE (PHARMD)
Entity type:Individual
Prefix:MS
First Name:ELYSE
Middle Name:JEANNETTE
Last Name:HOFFMAN
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 1:30257 MAYFAIR DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-2159
Mailing Address - Country:US
Mailing Address - Phone:248-788-0479
Mailing Address - Fax:
Practice Address - Street 1:2300 HAGGERTY RD STE 1070
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48323-2185
Practice Address - Country:US
Practice Address - Phone:248-668-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302027595183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist