Healthcare Provider Details

I. General information

NPI: 1104197862
Provider Name (Legal Business Name): MRS. SHARON HOFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2012
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MAPLE AVE
SARATOGA SPRINGS NY
12866-5504
US

IV. Provider business mailing address

21 VERDUN ST
WATERVLIET NY
12189-1221
US

V. Phone/Fax

Practice location:
  • Phone: 518-587-4551
  • Fax:
Mailing address:
  • Phone: 518-274-2999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number003544-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: