Provider Demographics
NPI:1528120698
Name:HOFFMAN, THOMAS ALEXANDER (PT)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ALEXANDER
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 SUMMIT AVE
Mailing Address - Street 2:STE 104
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1763
Mailing Address - Country:US
Mailing Address - Phone:201-627-0100
Mailing Address - Fax:201-746-6652
Practice Address - Street 1:160 SUMMIT AVE
Practice Address - Street 2:STE 104
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-1763
Practice Address - Country:US
Practice Address - Phone:201-627-0100
Practice Address - Fax:201-746-6652
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00806100225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ084984TEDMedicare ID - Type UnspecifiedRENDERING NUMBER