Provider Demographics
NPI:1508852179
Name:BAY RHEUMATOLOGY, M.D., P.C.
Entity Type:Organization
Organization Name:BAY RHEUMATOLOGY, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-498-3500
Mailing Address - Street 1:560 NORTHERN BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5113
Mailing Address - Country:US
Mailing Address - Phone:516-498-3500
Mailing Address - Fax:516-498-3517
Practice Address - Street 1:560 NORTHERN BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:GREATNECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5113
Practice Address - Country:US
Practice Address - Phone:516-498-3500
Practice Address - Fax:516-498-3517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY096586207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1508852179OtherNATIONAL PROVIDER IDENTIFIER-NPI
NYWJ6351OtherMEDICARE PTAN
NY0661510001Medicare NSC
NY82V281Medicare PIN