Healthcare Provider Details

I. General information

NPI: 1871087676
Provider Name (Legal Business Name): JENNIFER MARIE HOBEN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER MARIE DOUGHERTY

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 OLD MAIN ST STE 208
FISHKILL NY
12524-1883
US

IV. Provider business mailing address

111 CLOCK TOWER CMNS
BREWSTER NY
10509-4055
US

V. Phone/Fax

Practice location:
  • Phone: 845-231-0321
  • Fax: 877-309-4691
Mailing address:
  • Phone: 845-656-9715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number343077
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF405148
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: