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General NPI Number Information
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NPI Number | 1205907482
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Entity Type | Individual
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Provider Name | RAY STEPHAN HOFFMAN L. AC.
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Gender | Male
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 09/30/2013
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Provider Practice Location Address
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Address Line | 70 PARK ST #101
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City | MONTCLAIR
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State | NJ
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Zip | 07042-5907
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Country | US
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Telephone | 973-744-8771
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Fax | 973-744-8773
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Provider Business Mailing Address
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Address Line | 174 VALLEY RD
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City | MONTCLAIR
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State | NJ
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Zip | 07042-2323
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Country | US
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Telephone | 917-655-1509
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 02848
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MZ00057800
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License Number State | NJ
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