DR. PHILLIP FORMAN (NPI# 1386627412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386627412 |
| Entity Type | Individual |
| Full Name | DR. PHILLIP FORMAN |
| Credential | DPM |
| Practice Address |
242 Mason Ave Staten Island NY 10305-3408 |
| Mailing Address |
1 Edgewater St Suite 723 Staten Island NY 10305-4900 |
| Practice Telephone | 7182266340 |
| Practice Fax Number | 7182266178 |
| Mailing Telephone | 7182261047 |
| Mailing Fax Number | 7182261039 |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 005142 | NY | Podiatric Medicine & Surgery Service Providers |
| Street Address |
242 MASON AVE |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10305-3408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124001599 | Giovannie Jean-baptiste | Internal Medicine | 242 Mason Ave, Staten Island, NY 10305-3408 | 2005-11-21 |
| 1861058372 | Gautam Bhasin | Psychologist | 242 Mason Ave, Staten Island, NY 10305-3408 | 2019-05-10 |
| 1982018107 | Anna Shapiro | Audiologist | 242 Mason Ave, 1 Floor, Staten Island, NY 10305-3408 | 2014-06-16 |
| 1417254160 | Lydia Tripolsky | Pediatrics | 242 Mason Ave, Suite 1, Staten Island, NY 10305-3408 | 2011-02-15 |
| 1245545698 | Barry Lei | Occupational Therapist | 242 Mason Ave, Staten Island, NY 10305-3408 | 2010-08-10 |
| 1669783536 | Kimberly E Collins | Occupational Therapist | 242 Mason Ave, Staten Island, NY 10305-3408 | 2010-06-25 |
| 1932436854 | Mary Gundersen | Registered Nurse | 242 Mason Ave, Diabetes Education - 1st Floor, Staten Island, NY 10305-3408 | 2009-11-13 |
| 1306172689 | Jonathan Jacob Goldenthal | Pediatrics | 242 Mason Ave, Staten Island, NY 10305-3408 | 2009-10-21 |
| 1932343936 | Lydia Marty-meyerson | Nurse Practitioner | 242 Mason Ave, Staten Island, NY 10305-3408 | 2009-04-22 |
| 1023266111 | Judith Saltiel | Audiologist-Hearing Aid Fitter | 242 Mason Ave, Staten Island, NY 10305-3408 | 2008-09-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972101517 | Gina Sinchi | Specialist | 120 Hylan Blvd Suite 9b1, Staten Island, NY 10305 | 2020-10-15 |
| 1003436783 | Ali Kassem | Student in an Organized Health Care Education/Training Program | 475 Seaview University, Staten Island, New York, Staten Island University Hospital, Department of Intern, Staten Island, Nyc, NY 10305 | 2020-04-22 |
| 1174183982 | Mohammad Ass'ad Alshami | Student in an Organized Health Care Education/Training Program | 475 Seaview Avenue Ht-257(back), Staten Island-nyc, NY 10305 | 2019-06-14 |
| 1639632508 | Abdullah Jahangir | Student in an Organized Health Care Education/Training Program | 475 Seaview Avenue Staten Island, Staten Island Univers, New York City, NY 10305 | 2019-04-09 |
| 1922593813 | Ifeyinwa Mary Asuzu | Student in an Organized Health Care Education/Training Program | 1 Edgewater Plaza Staten Island, New York, NY 10305 | 2018-06-25 |
| 1700377652 | Celeste Jude Chow | Speech-Language Pathologist | 841 Father Capodanno Blvd, Staten Island, NY 10305 | 2018-05-27 |
| 1972094878 | Mahmoud Shadi | Student in an Organized Health Care Education/Training Program | 475 Seaview Avenue; Staten Island Univeristy Hospital, Staten Island, NY 10305 | 2018-05-25 |
| 1396235131 | Samyak Hiteshkumar Dhruv | Student in an Organized Health Care Education/Training Program | 475 Seaview Avenue, Staten Island, NY 10305 | 2018-05-17 |
| 1720583404 | Michele Corrado | Nurse Practitioner | 27 Xenia St, Staten Island, NY 10305 | 2018-03-26 |
| 1861995912 | Erika Renick | Dietitian, Registered | 256 Mason Avenue, Building C - 3rd Floor, Staten Island, NY 10305 | 2018-03-15 |
| Find all providers in zip 10305 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659835569 | Ipark Podiatry P.C. | Podiatrist | 970 Bard Avenue, Staten Island, NY 10301 | 2019-01-24 |
| 1457603391 | Michelle Zhubrak | Podiatrist | 175 Zoe St Apt 3m, Staten Island, NY 10305-1129 | 2012-10-02 |
| 1902100712 | Patrick Nowak | Podiatrist | 2984 Hylan Blvd, Staten Island, NY 10306-4060 | 2011-01-08 |
| 1881917748 | Julya A Keselman | Podiatrist | 229 Hales Ave, Staten Island, NY 10312-6102 | 2010-03-08 |
| 1104061498 | Janet Carney Dpm,pc | Podiatrist | 432 Clawson St, Staten Island, NY 10306-4350 | 2008-12-16 |
| 1710148135 | John P Terranella | Podiatrist | 2470 Victory Blvd, Staten Island, NY 10314-6612 | 2008-06-18 |
| 1417127705 | Ding Cheng Yang | Podiatrist | 66 Zachary Ct, Staten Island, NY 10310-2672 | 2008-03-03 |
| 1275716037 | Gary Spindler | Podiatrist | 386 Green Valley Rd, Staten Island, NY 10312-1820 | 2007-12-14 |
| 1992988364 | Deborah Marion Siegel | Podiatrist | 5656 Amboy Rd, Staten Island, NY 10309-3102 | 2007-12-08 |
| 1851599005 | Jon R Sundell Dpm PC | Podiatrist | 7355 Amboy Rd, Staten Island, NY 10307-1426 | 2007-07-10 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10305 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.