Provider Demographics
NPI:1952041857
Name:HOFMANN, JAMIE (L AC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:HOFMANN
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CROYDON
Mailing Address - State:PA
Mailing Address - Zip Code:19021-5403
Mailing Address - Country:US
Mailing Address - Phone:215-764-0127
Mailing Address - Fax:
Practice Address - Street 1:2014 FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-2602
Practice Address - Country:US
Practice Address - Phone:267-687-5655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK001386171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist