MEDICARE: MRS. SHARON HOFFMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	003544-1	NY

General Provider Information

NPI Number	:	1104197862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHARON HOFFMAN

Provider Business Mailing Address
First Line	:	21 VERDUN ST
Second Line	:
City	:	WATERVLIET
State	:	NY
Zip	:	12189-1221
Country	:	US
Telephone Number	:	518-274-2999
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 MAPLE AVE
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-5504
Country	:	US
Telephone Number	:	518-587-4551
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2012
Last Update Date	:	01/25/2012

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