Provider Demographics
NPI:1801097035
Name:ESSEX PULMONARY MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:ESSEX PULMONARY MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-783-5276
Mailing Address - Street 1:160 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-3802
Mailing Address - Country:US
Mailing Address - Phone:973-783-5276
Mailing Address - Fax:973-783-6014
Practice Address - Street 1:160 WALNUT ST
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-3802
Practice Address - Country:US
Practice Address - Phone:973-783-5276
Practice Address - Fax:973-783-6014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA036279207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMA036279OtherLICENSE
NJMB063752OtherLICENSE
NJH35776Medicare UPIN
NJ086219Medicare ID - Type UnspecifiedMEDICARE
NJMA036279OtherLICENSE