Provider Demographics
NPI:1326205576
Name:HOFFMAN, CARL M (MD)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:M
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 1:124 E 177TH ST
Mailing Address - Street 2:#2F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-5914
Mailing Address - Country:US
Mailing Address - Phone:212-576-7064
Mailing Address - Fax:
Practice Address - Street 1:124 E 177TH ST
Practice Address - Street 2:#2F
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-5914
Practice Address - Country:US
Practice Address - Phone:212-576-7064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY102700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine