Provider Demographics
NPI:1205907482
Name:HOFFMAN, RAY STEPHAN (L AC)
Entity type:Individual
Prefix:MR
First Name:RAY
Middle Name:STEPHAN
Last Name:HOFFMAN
Suffix:
Gender:M
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 1:174 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2323
Mailing Address - Country:US
Mailing Address - Phone:917-655-1509
Mailing Address - Fax:
Practice Address - Street 1:70 PARK ST
Practice Address - Street 2:#101
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-5907
Practice Address - Country:US
Practice Address - Phone:973-744-8771
Practice Address - Fax:973-744-8773
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02848171100000X
NJ25MZ00057800171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist