Formica, Marisa

Formica, Marisa is an individual health care provider with primary practice located at 101 Saint Andrews Ln , Glen Cove NY 11542-2254. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is her primary health care specialty. Formica, Marisa can be contacted via phone (516) 674-7631.

Contact Information

Primary practice address
101 Saint Andrews Ln Glen Cove NY 11542-2254
Phone: (516) 674-7631
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 280850 New York

Profile Details

NPI number 1568759041
LBN Legal business name Formica, Marisa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2011
Last updated Sep 3rd, 2015 - about 9 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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