Provider Demographics
NPI:1801986922
Name:HOFFMAN, SPENCER L (DC)
Entity type:Individual
Prefix:
First Name:SPENCER
Middle Name:L
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 UNION AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-3647
Mailing Address - Country:US
Mailing Address - Phone:732-295-1211
Mailing Address - Fax:732-295-7911
Practice Address - Street 1:28 UNION AVE STE 1
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-3647
Practice Address - Country:US
Practice Address - Phone:732-295-1211
Practice Address - Fax:732-295-7911
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00485300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ078434Medicare PIN