Healthcare Provider Details

I. General information

NPI: 1629164777
Provider Name (Legal Business Name): AMY HOFFMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 01/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 E 149TH ST SUITE 8D-200
BRONX NY
10451-5504
US

IV. Provider business mailing address

234 E 149TH ST SUITE 8D-200
BRONX NY
10451-5504
US

V. Phone/Fax

Practice location:
  • Phone: 718-579-4862
  • Fax: 718-579-4860
Mailing address:
  • Phone: 718-579-4862
  • Fax: 718-579-4860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number147062
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: