Provider Demographics
NPI:1497771943
Name:HOFELDT, GREGORY TODD (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:TODD
Last Name:HOFELDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1565 N MAIN ST
Mailing Address - Street 2:SUITE 406
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-2972
Mailing Address - Country:US
Mailing Address - Phone:508-677-0041
Mailing Address - Fax:508-677-2515
Practice Address - Street 1:1565 N MAIN ST
Practice Address - Street 2:SUITE 406
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-2972
Practice Address - Country:US
Practice Address - Phone:508-677-0041
Practice Address - Fax:508-677-0975
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2009-11-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY240012207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2141949Medicaid