Provider Demographics
NPI:1205197332
Name:HOFFMAN, GAYLE MICHELE
Entity type:Individual
Prefix:MRS
First Name:GAYLE
Middle Name:MICHELE
Last Name:HOFFMAN
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 1:70 PHILLIPS HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-4114
Mailing Address - Country:US
Mailing Address - Phone:845-639-2425
Mailing Address - Fax:
Practice Address - Street 1:70 PHILLIPS HILL RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-4114
Practice Address - Country:US
Practice Address - Phone:845-639-2425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY809575174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist