Healthcare Provider Details

I. General information

NPI: 1033276266
Provider Name (Legal Business Name): BERNICE HOFFMAN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 ONE HALF WEST 84TH ST 4A
NEW YORK NY
10024
US

IV. Provider business mailing address

11 ONE HALF WEST 84TH ST 4A
NEW YORK NY
10024
US

V. Phone/Fax

Practice location:
  • Phone: 212-362-0047
  • Fax:
Mailing address:
  • Phone: 212-362-0047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number005351
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: