Healthcare Provider Details

I. General information

NPI: 1124456983
Provider Name (Legal Business Name): RENEE HOBERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2013
Last Update Date: 11/16/2021
Certification Date: 11/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 WALNUT ST STE 601
PHILADELPHIA PA
19102-3516
US

IV. Provider business mailing address

40 PINE ST
PLAINVIEW NY
11803-2026
US

V. Phone/Fax

Practice location:
  • Phone: 610-892-3800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: