Forman, Bert Jeff

Forman, Bert Jeff is an individual health care provider with primary practice located at 1000 N Village Ave Mercy Medical Ctr, Rockville Ctr NY 11570. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Forman, Bert Jeff can be contacted via phone (516) 705-1212.

Contact Information

Primary practice address
1000 N Village Ave Mercy Medical Ctr Rockville Ctr NY 11570
Phone: (516) 705-1212
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 1481811 New York

Profile Details

NPI number 1811905847
LBN Legal business name Forman, Bert Jeff
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2006
Last updated Jul 8th, 2007 - about 17 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 1811905847 NPPES
New York MEDICAID 00913873

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