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General NPI Number Information
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NPI Number | 1649662388
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Entity Type | Individual
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Provider Name | EDIE HOCHBERG HOFSTATTER O.T.R.
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Gender | Female
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Dates
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Enumeration Date | 03/03/2015
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Last Update Date | 03/03/2015
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Provider Practice Location Address
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Address Line | 90 GREENWOODS RD W
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City | NORFOLK
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State | CT
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Zip | 06058-1249
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Country | US
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Telephone | 860-542-5459
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Fax |
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Provider Business Mailing Address
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Address Line | 90 GREENWOODS RD W
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City | NORFOLK
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State | CT
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Zip | 06058-1249
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Country | US
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Telephone |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 268
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1283
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 001142-1
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License Number State | NY
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