Forman, Laurie M

Forman, Laurie M is an individual health care provider with primary practice located at 2631 Merrick Rd Ste 205, Bellmore NY 11710. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Forman, Laurie M can be contacted via phone (516) 679-6673.

Contact Information

Primary practice address
2631 Merrick Rd Ste 205 Bellmore NY 11710
Phone: (516) 679-6673
Fax: (516) 679-6673
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X R0317371 New York

Profile Details

NPI number 1962508291
LBN Legal business name Forman, Laurie M
Credentials MS SOCIAL WORK
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962508291 NPPES
New York MEDICAID 00244817

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