Provider Demographics
NPI:1518212695
Name:HOFFMAN, JACQUELYN M (NP)
Entity Type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:M
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JACQUELYN
Other - Middle Name:M
Other - Last Name:SCHMIT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:550 1ST AVE
Mailing Address - Street 2:SUITE 7Q
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6402
Mailing Address - Country:US
Mailing Address - Phone:212-263-2361
Mailing Address - Fax:212-263-2019
Practice Address - Street 1:550 1ST AVE
Practice Address - Street 2:SUITE 7Q
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-2361
Practice Address - Fax:212-263-2019
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7023349163WG0000X
NY7869375363LA2200X
NYF-306093-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice