Provider Demographics
NPI:1346461621
Name:HOFFMAN, ALEXANDER (MD)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
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 1:130 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07028
Mailing Address - Country:US
Mailing Address - Phone:201-306-8623
Mailing Address - Fax:
Practice Address - Street 1:8518 FOURTH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209
Practice Address - Country:US
Practice Address - Phone:718-748-5482
Practice Address - Fax:718-748-3758
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097124208D00000X
NJ25MA02648200208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
505961Medicare ID - Type Unspecified
C10660Medicare UPIN