Healthcare Provider Details

I. General information

NPI: 1265476295
Provider Name (Legal Business Name): JEFFREY P HOFFMAN P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 03/22/2021
Certification Date: 03/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 GUTHRIE DR
CORNING NY
14830-3696
US

IV. Provider business mailing address

1 GUTHRIE SQ
SAYRE PA
18840-1625
US

V. Phone/Fax

Practice location:
  • Phone: 607-973-8294
  • Fax: 607-973-8311
Mailing address:
  • Phone: 570-888-5858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number003433
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: