Provider Demographics
NPI:1588647333
Name:HOFFMAN, ANDRE H (MD)
Entity Type:Individual
Prefix:
First Name:ANDRE
Middle Name:H
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 STEEPLEBUSH RUN
Mailing Address - Street 2:
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-3053
Mailing Address - Country:US
Mailing Address - Phone:267-241-4210
Mailing Address - Fax:856-467-6689
Practice Address - Street 1:141 STEEPLEBUSH RUN
Practice Address - Street 2:
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-3053
Practice Address - Country:US
Practice Address - Phone:267-241-4210
Practice Address - Fax:856-832-0169
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-25
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD420116207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJPENDINGMedicaid
PAPENDINGMedicaid
PAPENDINGMedicaid
PAPENDINGMedicare ID - Type Unspecified