Provider Demographics
NPI:1154310852
Name:HOOBERMAN, DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:HOOBERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 WELBY RD
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-1134
Mailing Address - Country:US
Mailing Address - Phone:508-995-5575
Mailing Address - Fax:508-995-0086
Practice Address - Street 1:17 COCASSET ST
Practice Address - Street 2:
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-2948
Practice Address - Country:US
Practice Address - Phone:508-995-5575
Practice Address - Fax:508-995-0086
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2009-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA499052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3012913Medicaid
MAJ02682Medicare ID - Type Unspecified
MAA56817Medicare UPIN