MEDICARE: DANIEL HOOBERMAN, MD, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	49905	MA

General Provider Information

NPI Number	:	1992862700
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL HOOBERMAN, MD, LLC

Provider Business Mailing Address
First Line	:	34 WELBY RD
Second Line	:	STE 205
City	:	NEW BEDFORD
State	:	MA
Zip	:	02745-1134
Country	:	US
Telephone Number	:	508-995-5575
Fax Number	:

Provider Business Practice Location Address
First Line	:	34 WELBY RD
Second Line	:	STE 205
City	:	NEW BEDFORD
State	:	MA
Zip	:	02745-1134
Country	:	US
Telephone Number	:	508-995-5575
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DANIEL HOOBERMAN
Credential	:	MD
Telephone Number	:	508-995-5575

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	08/11/2009

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