Healthcare Provider Details

I. General information

NPI: 1407819501
Provider Name (Legal Business Name): DR. DAVID HOFFMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

256C MASON AVE
STATEN ISLAND NY
10305-3408
US

IV. Provider business mailing address

256C MASON AVE
STATEN ISLAND NY
10305-3408
US

V. Phone/Fax

Practice location:
  • Phone: 718-226-1251
  • Fax: 718-226-1252
Mailing address:
  • Phone: 718-226-1251
  • Fax: 718-226-1252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number033292
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: