Provider Demographics
NPI:1174653703
Name:HOFFMAN, MELISA G (PT)
Entity Type:Individual
Prefix:MRS
First Name:MELISA
Middle Name:G
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:MELISA
Other - Middle Name:G
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2700 QUARRY LAKE DR
Mailing Address - Street 2:#300
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3746
Mailing Address - Country:US
Mailing Address - Phone:410-377-8900
Mailing Address - Fax:410-377-3156
Practice Address - Street 1:2700 QUARRY LAKE DR
Practice Address - Street 2:#300
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3746
Practice Address - Country:US
Practice Address - Phone:410-377-8900
Practice Address - Fax:410-377-3156
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2020-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22214225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist