Provider Demographics
NPI:1528041563
Name:HOFFMAN, DEBRA S (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:S
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2081 BALDWIN CT
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-5046
Mailing Address - Country:US
Mailing Address - Phone:917-882-4122
Mailing Address - Fax:
Practice Address - Street 1:2081 BALDWIN CT
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566
Practice Address - Country:US
Practice Address - Phone:917-882-4122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-23
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02207289Medicaid
H81243Medicare UPIN
NY685171Medicare ID - Type Unspecified