Provider Demographics
NPI:1184916348
Name:HOEFLER, KRISTIN
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:HOEFLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 ARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-1225
Mailing Address - Country:US
Mailing Address - Phone:631-521-7553
Mailing Address - Fax:631-863-9814
Practice Address - Street 1:22 ARTHUR ST
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-1225
Practice Address - Country:US
Practice Address - Phone:631-521-7553
Practice Address - Fax:631-863-9814
Is Sole Proprietor?:No
Enumeration Date:2011-05-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist