MEDICARE: MS. HOPE SUZANNE HOLMAN

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	39139	NY

General Provider Information

NPI Number	:	1942064142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HOPE SUZANNE HOLMAN

Provider Business Mailing Address
First Line	:	2588 7TH AVENUE, BLDG. #8, APT. 5R
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10039
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2588 7TH AVENUE, BLDG. #8, APT. 5R
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10039
Country	:	US
Telephone Number	:	917-499-0771
Fax Number	:

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

Provider Enumeration Date	:	02/08/2024
Last Update Date	:	02/08/2024

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