Healthcare Provider Details

I. General information

NPI: 1699127449
Provider Name (Legal Business Name): LAUREN HOFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2016
Last Update Date: 09/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 W 68TH ST APT 1109
NEW YORK NY
10023-5808
US

IV. Provider business mailing address

155 W 68TH ST APT 1109
NEW YORK NY
10023-5808
US

V. Phone/Fax

Practice location:
  • Phone: 610-574-2455
  • Fax:
Mailing address:
  • Phone: 610-574-2455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: