Provider Demographics
NPI:1013002559
Name:HOFFMAN, IRA R (MD)
Entity Type:Individual
Prefix:DR
First Name:IRA
Middle Name:R
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800A 5TH AVE
Mailing Address - Street 2:SUITE #301
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7215
Mailing Address - Country:US
Mailing Address - Phone:212-755-7711
Mailing Address - Fax:212-688-2207
Practice Address - Street 1:800A 5TH AVE
Practice Address - Street 2:SUITE #301
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7215
Practice Address - Country:US
Practice Address - Phone:212-755-7711
Practice Address - Fax:212-688-2207
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY80118170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY256911OtherMEDICARE ID
NYIH02569110Medicare PIN
NY256911OtherMEDICARE ID