Healthcare Provider Details

I. General information

NPI: 1144869397
Provider Name (Legal Business Name): SAMANTHA HOFFMAN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2020
Last Update Date: 01/04/2020
Certification Date: 01/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 GARDEN CITY PLZ
GARDEN CITY NY
11530-3302
US

IV. Provider business mailing address

1818 BELLMORE AVE
NORTH BELLMORE NY
11710-5554
US

V. Phone/Fax

Practice location:
  • Phone: 516-268-3026
  • Fax:
Mailing address:
  • Phone: 516-743-8660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF344528-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: