Healthcare Provider Details

I. General information

NPI: 1992669485
Provider Name (Legal Business Name): RONALD NICHOLAS HOFFMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

768 DELAWARE AVE
BUFFALO NY
14209-2006
US

IV. Provider business mailing address

768 DELAWARE AVE
BUFFALO NY
14209-2006
US

V. Phone/Fax

Practice location:
  • Phone: 716-882-3151
  • Fax: 716-886-4002
Mailing address:
  • Phone: 716-882-3151
  • Fax: 716-886-4002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number129157-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: