Provider Demographics
NPI:1639778293
Name:HOFFMAN, KILE (HIS)
Entity Type:Individual
Prefix:
First Name:KILE
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 MARLTON PIKE WEST
Mailing Address - Street 2:MIRACLE-EAR CENTER
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002
Mailing Address - Country:US
Mailing Address - Phone:856-471-7870
Mailing Address - Fax:856-665-6813
Practice Address - Street 1:3100 QUAKERBRIDGE RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-1658
Practice Address - Country:US
Practice Address - Phone:609-249-4257
Practice Address - Fax:856-665-6813
Is Sole Proprietor?:No
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MG00148500237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MG00148500OtherSTATE OF NJ HEARING AID DISPENSERS EXAMINING COMMITTEE