Provider Demographics
NPI:1154137677
Name:HOFMEISTER, NICHOLAS JAMES (DPT)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:JAMES
Last Name:HOFMEISTER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 OSBORN DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1323
Mailing Address - Country:US
Mailing Address - Phone:317-508-8443
Mailing Address - Fax:
Practice Address - Street 1:4960 BOILING BROOK PKWY
Practice Address - Street 2:
Practice Address - City:NORTH BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20852-2300
Practice Address - Country:US
Practice Address - Phone:240-541-5241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30208225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist