Provider Demographics
NPI:1598976169
Name:HOFFMAN, KENNETH ROBERT (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:ROBERT
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:956 PHELPS RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-5624
Mailing Address - Country:US
Mailing Address - Phone:201-294-3918
Mailing Address - Fax:201-837-0525
Practice Address - Street 1:956 PHELPS RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-5624
Practice Address - Country:US
Practice Address - Phone:201-294-3918
Practice Address - Fax:201-837-0525
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ45061207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD18964Medicare UPIN