Provider Demographics
NPI:1154575256
Name:THE COLLEGE OF ST. ROSE
Entity type:Organization
Organization Name:THE COLLEGE OF ST. ROSE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC
Authorized Official - Phone:518-439-7381
Mailing Address - Street 1:90 QUEEN ANNE DR
Mailing Address - Street 2:
Mailing Address - City:SLINGERLANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12159-9385
Mailing Address - Country:US
Mailing Address - Phone:518-439-7381
Mailing Address - Fax:
Practice Address - Street 1:432 WESTERN AVE
Practice Address - Street 2:THE COLLEGE OF SAINT ROSE
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203
Practice Address - Country:US
Practice Address - Phone:518-454-5263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002162-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency