Healthcare Provider Details

I. General information

NPI: 1538620281
Provider Name (Legal Business Name): DIANA B HOFSHI PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2019
Last Update Date: 03/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 W 75TH ST APT 1B
NEW YORK NY
10023-2156
US

IV. Provider business mailing address

15 W 75TH ST APT 1B
NEW YORK NY
10023-2156
US

V. Phone/Fax

Practice location:
  • Phone: 917-301-8592
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number023161
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: