Healthcare Provider Details

I. General information

NPI: 1447691209
Provider Name (Legal Business Name): MATTHEW A HOFFMAN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2013
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 E. 70TH STREET
NEW YORK NY
10021-2438
US

IV. Provider business mailing address

535 E. 70TH STREET
NEW YORK NY
10021-2438
US

V. Phone/Fax

Practice location:
  • Phone: 212-606-1000
  • Fax:
Mailing address:
  • Phone: 212-606-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number016645
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: