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General NPI Number Information
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NPI Number | 1255576302
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Entity Type | Individual
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Provider Name | JOSHUA HOOBERMAN PH.D.
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Gender | Male
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Dates
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Enumeration Date | 12/03/2008
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Last Update Date | 05/18/2016
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Provider Practice Location Address
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Address Line | 412 6TH AVE #709
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City | NEW YORK
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State | NY
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Zip | 10011-8409
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Country | US
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Telephone | 646-645-9709
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Fax |
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Provider Business Mailing Address
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Address Line | 155 LAFAYETTE AVE #3D
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City | BROOKLYN
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State | NY
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Zip | 11238-1074
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Country | US
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Telephone | 646-645-9709
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 017848
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License Number State | NY
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