Basic Information
| Provider Information | |||||||||
| NPI: | 1942404322 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LUCIA DIAS-HOFF, MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 829 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FALL RIVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027242921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5082350487 | ||||||||
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| Practice Location | |||||||||
| Address1: | 829 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FALL RIVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027242921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5082350487 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2007 | ||||||||
| LastUpdateDate: | 03/26/2008 | ||||||||
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| AuthorizedOfficialLastName: | DIAS-HOFF | ||||||||
| AuthorizedOfficialFirstName: | LUCIA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DOCTOR | ||||||||
| AuthorizedOfficialTelephone: | 5082350487 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | J17198 | 01 | MA | MA BLUE CROSS BLUE SHIELD | OTHER | M17992 | 01 | MA | MA BLUE CROSS BLUE SHIELD | OTHER | 3155731 | 05 | MA | MEDICAID |