Provider Demographics
NPI:1508189804
Name:HOFFMAN, DEENA KATHLEEN (PA-C)
Entity Type:Individual
Prefix:
First Name:DEENA
Middle Name:KATHLEEN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 2ND ST APT 4L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-2412
Mailing Address - Country:US
Mailing Address - Phone:347-277-2217
Mailing Address - Fax:
Practice Address - Street 1:416 2ND ST APT 4L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-2412
Practice Address - Country:US
Practice Address - Phone:347-277-2217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013865-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant