Provider Demographics
NPI:1679591135
Name:HOFFMANN, CAROLINE H (MS, RD, CDE)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:H
Last Name:HOFFMANN
Suffix:
Gender:F
Credentials:MS, RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 NORTHERN BLVD STE 207 2ND FLOOR
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5118
Mailing Address - Country:US
Mailing Address - Phone:516-466-1713
Mailing Address - Fax:
Practice Address - Street 1:560 NORTHERN BLVD STE 207 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5118
Practice Address - Country:US
Practice Address - Phone:516-466-1713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005660133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered