Healthcare Provider Details

I. General information

NPI: 1952407934
Provider Name (Legal Business Name): JUDITH HELAINE HOFFMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 10/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 W 86TH ST SUITE 3B
NEW YORK NY
10024-3666
US

IV. Provider business mailing address

PO BOX 95000-2388
PHILADELPHIA PA
19195-2388
US

V. Phone/Fax

Practice location:
  • Phone: 212-787-1788
  • Fax: 212-787-1606
Mailing address:
  • Phone: 212-308-1112
  • Fax: 212-308-1616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number236407
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: