Healthcare Provider Details

I. General information

NPI: 1740739523
Provider Name (Legal Business Name): BLIMA HOFFMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2016
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1312 38TH STREET
BROOKLYN NY
11218
US

IV. Provider business mailing address

6451 CENTRAL AVE
GLENDALE NY
11385-6258
US

V. Phone/Fax

Practice location:
  • Phone: 718-686-3700
  • Fax:
Mailing address:
  • Phone: 718-821-4424
  • Fax: 718-802-1113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number083945
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: