Provider Demographics
NPI:1275011330
Name:HOFFMAN, ERICA LEIA (MS)
Entity Type:Individual
Prefix:MS
First Name:ERICA
Middle Name:LEIA
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 RHINELANDER AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-3140
Mailing Address - Country:US
Mailing Address - Phone:216-650-2705
Mailing Address - Fax:
Practice Address - Street 1:PRIDE OF JUDEA COMMUNITY SERVICES
Practice Address - Street 2:243-02 NORTHERN BLVD.
Practice Address - City:DOUGLASTON
Practice Address - State:NY
Practice Address - Zip Code:11362
Practice Address - Country:US
Practice Address - Phone:718-423-6200
Practice Address - Fax:718-423-9762
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health