Basic Information
Provider Information
NPI: 1841533064
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOFFMAN
FirstName: DEANNA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1345 RXR PLZ FL 13
Address2:  
City: UNIONDALE
State: NY
PostalCode: 115561301
CountryCode: US
TelephoneNumber: 5164530435
FaxNumber: 6468453283
Practice Location
Address1: 216 E 14TH ST STE A
Address2:  
City: NEW YORK
State: NY
PostalCode: 100034105
CountryCode: US
TelephoneNumber: 2122561049
FaxNumber: 2122561059
Other Information
ProviderEnumerationDate: 04/06/2013
LastUpdateDate: 11/23/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X085004638ILN Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 
363A00000X016510NYY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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