Provider Demographics
NPI:1003825241
Name:HOFF, JESSICA L (PA-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:HOFF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 PARK AVE S
Mailing Address - Street 2:SUITE 15314
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-1208
Mailing Address - Country:US
Mailing Address - Phone:215-585-2144
Mailing Address - Fax:267-780-7032
Practice Address - Street 1:134 N 4TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249
Practice Address - Country:US
Practice Address - Phone:215-585-2144
Practice Address - Fax:267-780-7032
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051446363A00000X
NY011537363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02987415Medicaid
NYPA1827Medicare PIN
PAQ00154Medicare UPIN
NY02987415Medicaid