MEDICARE: DR. YARIV HOFSTEIN PHD

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	103TC0700X	Clinical Psychologist	018645	NY

General Provider Information

NPI Number	:	1700040607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YARIV HOFSTEIN PHD

Provider Business Mailing Address
First Line	:	305 W 52ND ST APT 3D
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10019-6232
Country	:	US
Telephone Number	:	413-320-7210
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 W 52ND ST APT 3D
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10019-6232
Country	:	US
Telephone Number	:	413-320-7210
Fax Number	:

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

Provider Enumeration Date	:	07/10/2008
Last Update Date	:	07/15/2020

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