=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356335343
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MR. ERIC S. HOFFMAN
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/06/2005
-----------------------------------------------------
Last Update Date | 07/14/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7 ESCHER DR
-----------------------------------------------------
City | MARLBORO
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07746-2223
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-972-3698
-----------------------------------------------------
Fax | 732-972-9040
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7 ESCHER DR
-----------------------------------------------------
City | MARLBORO
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07746-2223
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-972-3698
-----------------------------------------------------
Fax | 732-972-9040
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 222Z00000X
-----------------------------------------------------
Taxonomy Name | Orthotist
-----------------------------------------------------
License Number | PO 00001900
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 224P00000X
-----------------------------------------------------
Taxonomy Name | Prosthetist
-----------------------------------------------------
License Number | PO 00001900
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------