Provider Demographics
NPI:1972589745
Name:HOFMANN, ROBERT JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JEFFREY
Last Name:HOFMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 EAST MANNING ST.
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906
Mailing Address - Country:US
Mailing Address - Phone:401-272-2020
Mailing Address - Fax:401-421-5979
Practice Address - Street 1:150 EAST MANNING ST.
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906
Practice Address - Country:US
Practice Address - Phone:401-272-2020
Practice Address - Fax:401-421-5979
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD06877207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI153556OtherHARVARD
RI1619OtherNEIGHBORHOOD RI
RI003641OtherBLUE CHIP
RI26587OtherRI BLUE SHIELD
RIJ06051OtherMASS BLUE SHIELD
RI1659763OtherCIGNA
RI7000874Medicaid
PR763828OtherTUFTS
MA0021297OtherNEIGHBORHOOD MA
RI180036716OtherRAILROAD MEDICARE
RI0800142OtherUNITED
RI5729233OtherAETNA
RIM17477OtherBCBS MA GROUP #
RI003641OtherBLUE CHIP
RI189002658Medicare PIN
RI26587OtherRI BLUE SHIELD
RI0800142OtherUNITED
RI1619OtherNEIGHBORHOOD RI