Provider Demographics
NPI:1063548899
Name:HOFFLER, REGINALD ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:REGINALD
Middle Name:ANTHONY
Last Name:HOFFLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1468
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06506-1468
Mailing Address - Country:US
Mailing Address - Phone:203-387-0678
Mailing Address - Fax:
Practice Address - Street 1:1106 NORTH AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-2710
Practice Address - Country:US
Practice Address - Phone:203-579-6131
Practice Address - Fax:203-382-8464
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0259892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry