Healthcare Provider Details

I. General information

NPI: 1619927407
Provider Name (Legal Business Name): STUART M. HOFFMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 11/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 CORNELIA ST SUITE 102
PLATTSBURGH NY
12901-2317
US

IV. Provider business mailing address

11160 VERISMO ST
LAS VEGAS NV
89141-3442
US

V. Phone/Fax

Practice location:
  • Phone: 518-561-6410
  • Fax:
Mailing address:
  • Phone: 702-768-6881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number9758
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number254284
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number47994
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number129128
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: