Basic Information
| Provider Information | |||||||||
| NPI: | 1568815199 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOFFMANN | ||||||||
| FirstName: | MARSHA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
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| Credential: | RD, CDN | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SOMMERVIL | ||||||||
| OtherFirstName: | MARSHA | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4500 PARSONS BLVD | ||||||||
| Address2: | DEPT. OF FOOD & NUTRITION | ||||||||
| City: | FLUSHING | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113552205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186705000 | ||||||||
| FaxNumber: | 7186705614 | ||||||||
| Practice Location | |||||||||
| Address1: | 4500 PARSONS BLVD | ||||||||
| Address2: | DEPT. OF FOOD & NUTRITION | ||||||||
| City: | FLUSHING | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113552205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186705000 | ||||||||
| FaxNumber: | 7186705614 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2016 | ||||||||
| LastUpdateDate: | 05/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 008587 | NY | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.