Healthcare Provider Details

I. General information

NPI: 1871629899
Provider Name (Legal Business Name): BETH A. HOFFMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11050 71ST RD 1K
FOREST HILLS NY
11375-4969
US

IV. Provider business mailing address

11050 71ST RD 1K
FOREST HILLS NY
11375-4969
US

V. Phone/Fax

Practice location:
  • Phone: 718-390-8922
  • Fax: 718-225-1538
Mailing address:
  • Phone: 718-390-8922
  • Fax: 718-225-1538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number030127
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: