Provider Demographics
NPI:1992804884
Name:HOFFMAN, MARTIN (MD)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:HOFFMAN
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 1:1400 SWEET HOME RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2777
Mailing Address - Country:US
Mailing Address - Phone:716-932-6064
Mailing Address - Fax:716-932-6076
Practice Address - Street 1:219 BRYANT ST
Practice Address - Street 2:GENERAL PEDIATRIC DIVISION
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-2006
Practice Address - Country:US
Practice Address - Phone:716-878-7277
Practice Address - Fax:716-888-3966
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1165672081P0010X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY040426001393OtherFIDELIS
NY1208884OtherIHA
NY000507357009OtherBC/BS
NY00603301Medicaid
NY000507357008OtherBC/BS
NY0018712610001OtherPA MEDICAID
NY00010077801OtherUNIVERA
NY0018712610001OtherPA MEDICAID
NY00603301Medicaid