Healthcare Provider Details

I. General information

NPI: 1255606257
Provider Name (Legal Business Name): KAREN HOFFMAN D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2012
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 W 168TH ST
NEW YORK NY
10032-3725
US

IV. Provider business mailing address

630 W 168TH ST
NEW YORK NY
10032-3725
US

V. Phone/Fax

Practice location:
  • Phone: 212-342-3008
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number061583-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: