Provider Demographics
NPI:1013651967
Name:HOFSTEIN-AMSELEM, CAROLE HOFSTEIN
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:HOFSTEIN
Last Name:HOFSTEIN-AMSELEM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 BROOME ST APT 22
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-3824
Mailing Address - Country:US
Mailing Address - Phone:929-320-8401
Mailing Address - Fax:
Practice Address - Street 1:32 PEBBLE LN
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2712
Practice Address - Country:US
Practice Address - Phone:929-320-8398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011755101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health