DR. JESSICA FORMAN (NPI# 1629359948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629359948 |
| Entity Type | Individual |
| Full Name | DR. JESSICA FORMAN |
| Credential | PSY.D. |
| Practice Address |
120 E 87th St Apt P18b New York NY 10128-1119 |
| Practice Telephone | 2129873601 |
| Mailing Telephone | 2129873601 |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2011-08-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
017262 | NY | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124635602 | Jessica Leigh Forman | Behavioral Analyst | 340 E 1st Ave Ste 102, Broomfield, CO 80020-2454 | 2020-09-28 |
| 1114067212 | Jessica S. Forman | Physician Assistant | 177 Fort Washington Ave, 5th Floor - 5 Garden North, New York, NY 10032-3733 | 2007-02-07 |
| Street Address |
120 E 87TH ST APT P18B |
| City | NEW YORK |
| State | NY |
| Zip Code | 10128-1119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326671314 | Kathleen Forhan | Student in an Organized Health Care Education/Training Program | 116 East 92nd Street, Bsmnt, New York, NY 10128 | 2020-02-18 |
| 1811539638 | Baron Shieh | Physical Therapist | 1844 Second Ave, New York, NY 10128 | 2019-10-14 |
| 1720641335 | Michael Gary Rothenberg | Psychologist | 5 East 94th Street, New York, NY 10128 | 2019-04-18 |
| 1275003865 | Desiree Caban | Psychoanalyst | 1449 Lexington Ave 4b1 East, New York, NY 10128 | 2018-11-27 |
| 1326514191 | Yjk Anesthesia LLC | Anesthesiology | 403 East 91st, New York, NY 10128 | 2018-10-19 |
| 1619454568 | Arthur Jenkins Md LLC | Neurological Surgery | 65 Eat 96th Street, Suite 1b, New York, NY 10128 | 2018-07-24 |
| 1285120832 | Eric Axel Gerdner | Social Worker | 309 E 94th St Fl 4, New York, NY 10128 | 2018-07-06 |
| 1003317694 | Max I Bolotin | Psychologist | 49 East 96 Street Apt 12d, New York, NY 10128 | 2018-02-28 |
| 1518471465 | Elyse Palumbo | Social Worker | 305 East 92nd Street, New York, NY 10128 | 2017-11-29 |
| 1720505282 | Arlene Kramer Richards | Psychologist | 200 East89 Street, 45bc, New York, NY 10128 | 2017-08-25 |
| Find all providers in zip 10128 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114560398 | Alison Melville Locker | Psychologist | 375 Greenwich St Ste 812, New York, NY 10013-2376 | 2019-10-21 |
| 1417502543 | Norma Linda Doft | Psychologist | 295 Central Park W Ofc 4a, New York, NY 10024-3021 | 2019-08-06 |
| 1598293300 | Cassie Fromowitz | Psychologist | 41 Madison Ave Ste 2541, New York, NY 10010-2202 | 2017-05-24 |
| 1063877512 | Joyce Dweck | Psychologist | 60 Madison Ave Ste 1004, New York, NY 10010-1640 | 2015-12-29 |
| 1184005381 | Jessica Leah Delman | Psychologist | 635 W 168th St # B-18, New York, NY 10032-3703 | 2015-06-12 |
| 1760862593 | Joanna Stern | Psychologist | 101 East 56th Street, New York, NY 10022 | 2015-06-07 |
| 1770970196 | Cara Remmes | Psychologist | 3959 Broadway Chony 6 North, Ms Children's Hospital of Nyp, New York, NY 10032 | 2015-04-23 |
| 1174913370 | Rebecca Hutt | Psychologist | 255 W 101st St, 1st Floor, New York, NY 10025-4974 | 2015-01-27 |
| 1447648753 | Victoria I Phillips | Psychologist | 10 W 65th St Apt 5d, New York, NY 10023-6639 | 2015-01-08 |
| 1588006050 | Joselyn Fine | Psychologist | 740 W End Ave Apt 5, New York, NY 10025-6256 | 2013-07-24 |
| Find all providers in NEW YORK | ||||
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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.