Provider Demographics
NPI:1558139063
Name:HOFFMAN, PAIGE MARIE
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:MARIE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ASHLEY LN
Mailing Address - Street 2:
Mailing Address - City:SHOREHAM
Mailing Address - State:NY
Mailing Address - Zip Code:11786-1422
Mailing Address - Country:US
Mailing Address - Phone:631-438-6023
Mailing Address - Fax:
Practice Address - Street 1:15 ASHLEY LN
Practice Address - Street 2:
Practice Address - City:SHOREHAM
Practice Address - State:NY
Practice Address - Zip Code:11786-1422
Practice Address - Country:US
Practice Address - Phone:631-438-6023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY32734001164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse