Healthcare Provider Details

I. General information

NPI: 1528120698
Provider Name (Legal Business Name): THOMAS ALEXANDER HOFFMAN P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 05/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 SUMMIT AVE STE 104
MONTVALE NJ
07645-1763
US

IV. Provider business mailing address

160 SUMMIT AVE STE 104
MONTVALE NJ
07645-1763
US

V. Phone/Fax

Practice location:
  • Phone: 201-627-0100
  • Fax: 201-746-6652
Mailing address:
  • Phone: 201-627-0100
  • Fax: 201-746-6652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00806100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number40QA00806100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: