Provider Demographics
NPI:1407996994
Name:HOFMANN PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:HOFMANN PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOFMANN
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPY
Authorized Official - Phone:914-630-4830
Mailing Address - Street 1:444 BOSTON POST RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-3500
Mailing Address - Country:US
Mailing Address - Phone:914-630-4830
Mailing Address - Fax:914-630-4832
Practice Address - Street 1:444 BOSTON POST RD
Practice Address - Street 2:SUITE 103
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-3500
Practice Address - Country:US
Practice Address - Phone:914-630-4830
Practice Address - Fax:914-630-4832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0185861225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQAWXW1Medicare PIN