Provider Demographics
NPI:1417105388
Name:SANDRA J. HOFFMAN, ED.D., PC
Entity Type:Organization
Organization Name:SANDRA J. HOFFMAN, ED.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:301-816-0202
Mailing Address - Street 1:10815 LUXBERRY DR
Mailing Address - Street 2:
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-5505
Mailing Address - Country:US
Mailing Address - Phone:301-816-0202
Mailing Address - Fax:202-328-2189
Practice Address - Street 1:1700 17TH ST NW
Practice Address - Street 2:SUITE 201
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2453
Practice Address - Country:US
Practice Address - Phone:202-328-2283
Practice Address - Fax:202-328-2189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1314103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
491808Medicare PIN