Provider Demographics
NPI:1851472617
Name:HOFFMANN, URSULA M (MD)
Entity Type:Individual
Prefix:
First Name:URSULA
Middle Name:M
Last Name:HOFFMANN
Suffix:
Gender:F
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:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:CENTER VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18034-0158
Mailing Address - Country:US
Mailing Address - Phone:610-282-4030
Mailing Address - Fax:610-282-4492
Practice Address - Street 1:6099A MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-0158
Practice Address - Country:US
Practice Address - Phone:610-282-4030
Practice Address - Fax:610-282-4492
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022232E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA063310Medicare PIN