=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396988382
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOFFMAN & MARINO LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/07/2009
-----------------------------------------------------
Last Update Date | 04/07/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4224 HOUMA BLVD STE 140
-----------------------------------------------------
City | METAIRIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70006-2933
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-888-8880
-----------------------------------------------------
Fax | 504-454-5001
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4224 HOUMA BLVD STE 140
-----------------------------------------------------
City | METAIRIE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70006
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-454-5001
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | EUGENE HOFFMAN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 504-888-8880
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207VG0400X
-----------------------------------------------------
Taxonomy Name | Gynecology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------