Provider Demographics
NPI:1326372202
Name:HOFFMAN, GREGORY R (PT)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:R
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 AVENUE X
Mailing Address - Street 2:APT 3D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-6051
Mailing Address - Country:US
Mailing Address - Phone:718-690-0313
Mailing Address - Fax:
Practice Address - Street 1:475 E 57TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-6010
Practice Address - Country:US
Practice Address - Phone:718-451-5213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013180-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist