Provider Demographics
NPI:1629306402
Name:HOFFENBERG, JOAN DIANE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:DIANE
Last Name:HOFFENBERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 WELLINGTON CT
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-2434
Mailing Address - Country:US
Mailing Address - Phone:718-434-3356
Mailing Address - Fax:718-859-4441
Practice Address - Street 1:49 WELLINGTON CT
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-2434
Practice Address - Country:US
Practice Address - Phone:718-434-3356
Practice Address - Fax:718-859-4441
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-07
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009881103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical