Provider Demographics
NPI:1831190008
Name:HOFFMAN, MICHAEL L (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:L
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:560 NORTHERN BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5113
Mailing Address - Country:US
Mailing Address - Phone:516-498-3500
Mailing Address - Fax:516-498-3517
Practice Address - Street 1:560 NORTHERN BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5113
Practice Address - Country:US
Practice Address - Phone:516-498-3500
Practice Address - Fax:516-498-3517
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY096586207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1831190008OtherNATIONAL PROVIDER IDENTIFIER-NPI
NY82V28J6351OtherMEDICARE PTAN
NY82V28J6351OtherMEDICARE PTAN
NY82V281Medicare PIN