Provider Demographics
NPI:1306550827
Name:HOFFMAN, EMILY ELAINE (LAT, ATC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ELAINE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-1720
Mailing Address - Country:US
Mailing Address - Phone:339-224-1364
Mailing Address - Fax:
Practice Address - Street 1:200 UNICORN DR
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-3324
Practice Address - Country:US
Practice Address - Phone:781-782-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA31012255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer