Healthcare Provider Details

I. General information

NPI: 1063005015
Provider Name (Legal Business Name): SHARON ANN HOFERER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2021
Last Update Date: 02/19/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 DAVIS AVE
POUGHKEEPSIE NY
12603-2408
US

IV. Provider business mailing address

PO BOX 114
ESOPUS NY
12429-0114
US

V. Phone/Fax

Practice location:
  • Phone: 845-218-1602
  • Fax:
Mailing address:
  • Phone: 845-384-6832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: