Healthcare Provider Details

I. General information

NPI: 1497180194
Provider Name (Legal Business Name): DIANE HOFFMAN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2013
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 SPRUCE LN
WEST NYACK NY
10994-2118
US

IV. Provider business mailing address

2 SPRUCE LN
WEST NYACK NY
10994-2118
US

V. Phone/Fax

Practice location:
  • Phone: 845-641-8946
  • Fax:
Mailing address:
  • Phone: 845-641-8946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number014132-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00530200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: