MEDICARE: MR. THOMAS ALEXANDER HOFFMAN P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	40QA00806100	NJ
2	2251X0800X	Orthopedic Physical Therapist	40QA00806100	NJ

General Provider Information

NPI Number	:	1528120698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS ALEXANDER HOFFMAN P.T.

Provider Business Mailing Address
First Line	:	160 SUMMIT AVE
Second Line	:	STE 104
City	:	MONTVALE
State	:	NJ
Zip	:	07645-1763
Country	:	US
Telephone Number	:	201-627-0100
Fax Number	:	201-746-6652

Provider Business Practice Location Address
First Line	:	160 SUMMIT AVE
Second Line	:	STE 104
City	:	MONTVALE
State	:	NJ
Zip	:	07645-1763
Country	:	US
Telephone Number	:	201-627-0100
Fax Number	:	201-746-6652

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	05/30/2019

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