Healthcare Provider Details

I. General information

NPI: 1699979849
Provider Name (Legal Business Name): ROBERT J HOFFNUNG PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 WHITNEY AVE
NEW HAVEN CT
06511-7204
US

IV. Provider business mailing address

303 WHITNEY AVE
NEW HAVEN CT
06511-7204
US

V. Phone/Fax

Practice location:
  • Phone: 203-777-0244
  • Fax: 203-785-1247
Mailing address:
  • Phone: 203-777-0244
  • Fax: 203-785-1247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number891
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: