Provider Demographics
NPI:1922165687
Name:HOFFER, NANCY JOSEPHINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:JOSEPHINE
Last Name:HOFFER
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 1:222 BROADWAY FL 19
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-2550
Mailing Address - Country:US
Mailing Address - Phone:212-217-2064
Mailing Address - Fax:212-732-5617
Practice Address - Street 1:222 BROADWAY FL 19
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-2550
Practice Address - Country:US
Practice Address - Phone:212-217-2064
Practice Address - Fax:212-732-5617
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013633-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01899421Medicaid