Provider Demographics
NPI:1588835870
Name:HOFFMAN, MADELYN KAY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MADELYN
Middle Name:KAY
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 WEST 74TH
Mailing Address - Street 2:APT 2B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2213
Mailing Address - Country:US
Mailing Address - Phone:917-660-4966
Mailing Address - Fax:212-579-4436
Practice Address - Street 1:#2 WEST 86TH STREET
Practice Address - Street 2:#506 SUITE 5
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024
Practice Address - Country:US
Practice Address - Phone:212-874-4824
Practice Address - Fax:212-579-4436
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0166801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNS2060OtherOXFORD
NY1-C N98231Medicare PIN