Provider Demographics
NPI:1578670196
Name:HOFFMANN, ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:HOFFMANN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 FLETCHER AVE
Mailing Address - Street 2:#7
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-4000
Mailing Address - Country:US
Mailing Address - Phone:516-872-0680
Mailing Address - Fax:516-872-1091
Practice Address - Street 1:15 FLETCHER AVE
Practice Address - Street 2:#7
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-4000
Practice Address - Country:US
Practice Address - Phone:516-872-0680
Practice Address - Fax:516-872-1091
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX67711111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U96429Medicare UPIN
NYX6H121Medicare PIN