Healthcare Provider Details

I. General information

NPI: 1902037369
Provider Name (Legal Business Name): DR. DANIEL L HOFFMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2009
Last Update Date: 06/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6143 186TH ST
FRESH MEADOWS NY
11365-2710
US

IV. Provider business mailing address

14411 69TH AVE
FLUSHING NY
11367-1709
US

V. Phone/Fax

Practice location:
  • Phone: 516-874-6854
  • Fax:
Mailing address:
  • Phone: 516-874-6854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number18861
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number18861
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: