Provider Demographics
NPI:1184340226
Name:HOFFMAN, MIRIAM ARIELLA (NP)
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:ARIELLA
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CLUB DR APT 4CL
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2005
Mailing Address - Country:US
Mailing Address - Phone:732-600-6350
Mailing Address - Fax:
Practice Address - Street 1:3923 FORT HAMILTON PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-1916
Practice Address - Country:US
Practice Address - Phone:929-491-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY349998363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily