Provider Demographics
NPI:1427372861
Name:HOFFMANN-GAHAGEN, SUZETTE M (RPH)
Entity type:Individual
Prefix:MRS
First Name:SUZETTE
Middle Name:M
Last Name:HOFFMANN-GAHAGEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 N AMERICA DR
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-2225
Mailing Address - Country:US
Mailing Address - Phone:716-675-3784
Mailing Address - Fax:
Practice Address - Street 1:40 N AMERICA DR
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-2225
Practice Address - Country:US
Practice Address - Phone:716-675-3784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-14
Last Update Date:2010-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036916183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist