1205224227 NPI number — LAURALEE PUDUP HOFFNER MA, CCC-SLP

Table of content: LAURALEE PUDUP HOFFNER MA, CCC-SLP (NPI 1205224227)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205224227 NPI number — LAURALEE PUDUP HOFFNER MA, CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOFFNER
Provider First Name:
LAURALEE
Provider Middle Name:
PUDUP
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PUDUP
Provider Other First Name:
LAURALEE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA, CCC-SLP
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1205224227
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/29/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 UNIVERSITY DR
Provider Second Line Business Mailing Address:
MC A410
Provider Business Mailing Address City Name:
HERSHEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17033-2360
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-243-1955
Provider Business Mailing Address Fax Number:
717-531-7269

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30 HOPE DR
Provider Second Line Business Practice Location Address:
BUILDING B SUITE 1500 MC EC130
Provider Business Practice Location Address City Name:
HERSHEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17033-2036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-531-8070
Provider Business Practice Location Address Fax Number:
717-531-0138
Provider Enumeration Date:
12/29/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  SL010371 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com