MEDICARE: MR. EDWARD O HOBERMAN MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	102L00000X	Psychoanalyst	0001091	NY

General Provider Information

NPI Number	:	1366600512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EDWARD O HOBERMAN MA

Provider Business Mailing Address
First Line	:	685 WEST END AVENUE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10025-6819
Country	:	US
Telephone Number	:	212-666-9412
Fax Number	:

Provider Business Practice Location Address
First Line	:	685 WEST END AVENUE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10025-6819
Country	:	US
Telephone Number	:	212-666-9412
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2008
Last Update Date	:	05/23/2008

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Directions to “ MR. EDWARD O HOBERMAN MA” Practice Location

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