Healthcare Provider Details

I. General information

NPI: 1104893155
Provider Name (Legal Business Name): LUCIA DIAS-HOFF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 FOLEY ST
SOMERVILLE MA
02145-1213
US

IV. Provider business mailing address

1207 N ST NW APT E
WASHINGTON DC
20005-5108
US

V. Phone/Fax

Practice location:
  • Phone: 857-282-0777
  • Fax:
Mailing address:
  • Phone: 401-473-5295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number150671
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-22734
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: