Provider Demographics
NPI:1952547218
Name:HOFFMAN, DAVID P (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:P
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MOUNT VERNON ST STE 208
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-2724
Mailing Address - Country:US
Mailing Address - Phone:781-787-2708
Mailing Address - Fax:617-300-8896
Practice Address - Street 1:1 MOUNT VERNON ST STE 208
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-2724
Practice Address - Country:US
Practice Address - Phone:781-787-2708
Practice Address - Fax:617-300-8896
Is Sole Proprietor?:No
Enumeration Date:2008-12-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002353103TC2200X
MA10241103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA10241OtherPSYCHOLOGY LICENSURE
CT90-0454262OtherEIN