Provider Demographics
NPI:1629837869
Name:HOFMAN, AGNIESZKA (PT)
Entity Type:Individual
Prefix:MRS
First Name:AGNIESZKA
Middle Name:
Last Name:HOFMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 HOYT ST UNIT L10
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5725
Mailing Address - Country:US
Mailing Address - Phone:917-670-4825
Mailing Address - Fax:
Practice Address - Street 1:143 HOYT ST UNIT L10
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5725
Practice Address - Country:US
Practice Address - Phone:917-670-4825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT013512208100000X, 225100000X
CT013513225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation