Healthcare Provider Details

I. General information

NPI: 1477667822
Provider Name (Legal Business Name): HOWARD R HOFFMAN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3585 HYLAN BLVD
STATEN ISLAND NY
10308
US

IV. Provider business mailing address

3585 HYLAN BLVD
STATEN ISLAND NY
10308
US

V. Phone/Fax

Practice location:
  • Phone: 718-948-7103
  • Fax: 718-356-6767
Mailing address:
  • Phone: 718-948-7103
  • Fax: 718-356-6767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number031774
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: