Provider Demographics
NPI:1255593075
Name:S. DENISE HOFFMAN M.D. FAMILY MEDICINE
Entity type:Organization
Organization Name:S. DENISE HOFFMAN M.D. FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT /PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-337-9997
Mailing Address - Street 1:860 1ST AVE
Mailing Address - Street 2:SUITE 4A
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-4033
Mailing Address - Country:US
Mailing Address - Phone:610-337-9997
Mailing Address - Fax:610-265-1441
Practice Address - Street 1:860 1ST AVE
Practice Address - Street 2:SUITE 4A
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-4033
Practice Address - Country:US
Practice Address - Phone:610-337-9997
Practice Address - Fax:610-265-1441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044986L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF21083Medicare UPIN
PA070366Medicare PIN