Healthcare Provider Details
I. General information
NPI: 1134645310
Provider Name (Legal Business Name): RYAN PHILIP HOFFMAN O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/18/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6B MINNEAKONING RD
FLEMINGTON NJ
08822-5760
US
IV. Provider business mailing address
6B MINNEAKONING RD
FLEMINGTON NJ
08822-5760
US
V. Phone/Fax
- Phone: 908-824-7144
- Fax:
- Phone: 908-824-7144
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 27OA00675700 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | 27OA00675700 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: