Provider Demographics
NPI:1689121774
Name:HOFFMAN, DANIEL RYAN (CAS)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:RYAN
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 MERCER ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-3616
Mailing Address - Country:US
Mailing Address - Phone:845-323-9639
Mailing Address - Fax:
Practice Address - Street 1:53 MERCER ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-3616
Practice Address - Country:US
Practice Address - Phone:845-323-9639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1074521161103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist