Healthcare Provider Details

I. General information

NPI: 1952547218
Provider Name (Legal Business Name): DAVID P HOFFMAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2008
Last Update Date: 03/16/2023
Certification Date: 03/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MOUNT VERNON ST STE 208
WINCHESTER MA
01890-2724
US

IV. Provider business mailing address

1 MOUNT VERNON ST STE 208
WINCHESTER MA
01890-2724
US

V. Phone/Fax

Practice location:
  • Phone: 781-787-2708
  • Fax: 617-300-8896
Mailing address:
  • Phone: 781-787-2708
  • Fax: 617-300-8896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number002353
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number10241
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: