Healthcare Provider Details

I. General information

NPI: 1588729222
Provider Name (Legal Business Name): BRUCE SCOTT HOFFMAN PSYD.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1470 E 70TH ST
BROOKLYN NY
11234-5712
US

IV. Provider business mailing address

1470 E 70TH ST
BROOKLYN NY
11234-5712
US

V. Phone/Fax

Practice location:
  • Phone: 718-968-9557
  • Fax: 347-374-4193
Mailing address:
  • Phone: 718-968-9557
  • Fax: 347-374-4193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number012887-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: