Provider Demographics
NPI:1912392903
Name:HOFFMAN, MELISSA BROOKE (MD)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:BROOKE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3041 ORCHARD PARK RD
Mailing Address - Street 2:STE C
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1238
Mailing Address - Country:US
Mailing Address - Phone:716-674-3104
Mailing Address - Fax:716-674-0666
Practice Address - Street 1:6420 TRANSIT RD STE A
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-1033
Practice Address - Country:US
Practice Address - Phone:716-845-1600
Practice Address - Fax:716-242-0201
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY328926207N00000X
WI70914207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology