Forman, Evan M

Forman, Evan M is an individual health care provider with primary practice located at 245 N 15Th St Ms 515, Philadelphia PA 19102-1101. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Forman, Evan M can be contacted via phone (215) 762-4021.

Contact Information

Primary practice address
245 N 15Th St Ms 515 Philadelphia PA 19102-1101
Phone: (215) 762-4021
Fax: (215) 762-8706
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PS 015133 Pennsylvania

Profile Details

NPI number 1841254950
LBN Legal business name Forman, Evan M
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 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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