Provider Demographics
NPI:1336585405
Name:HOFFMAN, ANDREW MARK (MA,EDS, LMFT)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:MARK
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MA,EDS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-4955
Mailing Address - Country:US
Mailing Address - Phone:973-865-0506
Mailing Address - Fax:
Practice Address - Street 1:2 EAST NORTHFIELD ROAD
Practice Address - Street 2:SUITE 5
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-9998
Practice Address - Country:US
Practice Address - Phone:973-865-0506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37F100175000106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ216352Medicaid