Provider Demographics
NPI:1679695159
Name:HOFFMAN, RONALD L (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:L
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:776 6TH AVE
Mailing Address - Street 2:SUITE 4B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6354
Mailing Address - Country:US
Mailing Address - Phone:212-779-1744
Mailing Address - Fax:212-779-0891
Practice Address - Street 1:776 6TH AVE
Practice Address - Street 2:SUITE 4B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6354
Practice Address - Country:US
Practice Address - Phone:212-779-1744
Practice Address - Fax:212-779-0891
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2015-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYA158621-1208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA61212Medicare UPIN