Healthcare Provider Details
I. General information
NPI: 1043389984
Provider Name (Legal Business Name): LOWELL W HOFFMAN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7540 WINDSOR DR SUITE 105
ALLENTOWN PA
18195
US
IV. Provider business mailing address
PO BOX 425
FOGELSVILLE PA
18051
US
V. Phone/Fax
- Phone: 610-395-3005
- Fax: 610-391-1711
- Phone: 610-395-3005
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PS5276L |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: