Provider Demographics
NPI:1043519754
Name:HOFMANN-LEVIN, SUSAN (LMT, L AC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:HOFMANN-LEVIN
Suffix:
Gender:F
Credentials:LMT, L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6911 YELLOWSTONE BLVD APT B32
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3789
Mailing Address - Country:US
Mailing Address - Phone:631-240-4196
Mailing Address - Fax:
Practice Address - Street 1:415 W 57TH ST APT B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1753
Practice Address - Country:US
Practice Address - Phone:917-599-2179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-21
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY27 019417225700000X
NY25 004557171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist