Provider Demographics
NPI:1962997874
Name:HOFFMAN, SUSAN R (EDD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:R
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W 89TH ST APT 8A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1819
Mailing Address - Country:US
Mailing Address - Phone:917-620-0341
Mailing Address - Fax:
Practice Address - Street 1:201 W 89TH ST APT 8A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1819
Practice Address - Country:US
Practice Address - Phone:917-620-0341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2427103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling