Provider Demographics
NPI:1932184405
Name:HOFFMAN, MARK MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:MICHAEL
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 PARK STREET
Mailing Address - Street 2:GLENS FALLS HOSPITAL - CREDENTIALING
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-4413
Mailing Address - Country:US
Mailing Address - Phone:518-926-5924
Mailing Address - Fax:518-926-6983
Practice Address - Street 1:102 PARK STREET
Practice Address - Street 2:CR WOOD CANCER CENTER
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801
Practice Address - Country:US
Practice Address - Phone:518-926-6620
Practice Address - Fax:518-926-6626
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2021-06-29
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Provider Licenses
StateLicense IDTaxonomies
NY1540861207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00962730Medicaid
NYC59370Medicare UPIN
NY56254BMedicare ID - Type Unspecified