Provider Demographics
NPI:1104893155
Name:DIAS-HOFF, LUCIA (MD)
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:
Last Name:DIAS-HOFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 N ST NW APT E
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-5108
Mailing Address - Country:US
Mailing Address - Phone:401-473-5295
Mailing Address - Fax:
Practice Address - Street 1:440 FOLEY ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02145-1213
Practice Address - Country:US
Practice Address - Phone:857-282-0777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA150671207Q00000X
HIMD-22734207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3155731Medicaid
MAJ17198OtherMA BCBS
MAM17992OtherMA BCBS
MA3155731Medicaid
F86274Medicare UPIN