Provider Demographics
NPI:1043389984
Name:HOFFMAN, LOWELL W (PHD)
Entity Type:Individual
Prefix:DR
First Name:LOWELL
Middle Name:W
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 425
Mailing Address - Street 2:
Mailing Address - City:FOGELSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18051
Mailing Address - Country:US
Mailing Address - Phone:610-395-3005
Mailing Address - Fax:
Practice Address - Street 1:7540 WINDSOR DR
Practice Address - Street 2:SUITE 105
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18195
Practice Address - Country:US
Practice Address - Phone:610-395-3005
Practice Address - Fax:610-391-1711
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS5276L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01370002OtherCAPITAL BLUE CROSS PA
PA0291628000OtherINDEPENDENCE BLUE CROSS
PA000043OtherHIGHMARK BLUE SHIELD PA
PA000043Medicare ID - Type Unspecified