Healthcare Provider Details

I. General information

NPI: 1174890073
Provider Name (Legal Business Name): JENNIFER M. HOFFMAN L.C.S.W
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2011
Last Update Date: 11/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 JEAN PL
SYOSSET NY
11791-5914
US

IV. Provider business mailing address

7 JEAN PL
SYOSSET NY
11791-5914
US

V. Phone/Fax

Practice location:
  • Phone: 917-499-6767
  • Fax: 516-364-3780
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number076489-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: