Healthcare Provider Details

I. General information

NPI: 1477873776
Provider Name (Legal Business Name): LORNA CORDELLA FORBES FNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2010
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 E GENESEE ST BLDG D
FAYETTEVILLE NY
13066-1131
US

IV. Provider business mailing address

8417 HOBNAIL RD
MANLIUS NY
13104-9332
US

V. Phone/Fax

Practice location:
  • Phone: 315-234-3896
  • Fax: 315-748-5377
Mailing address:
  • Phone: 315-420-1546
  • Fax: 315-748-5377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF336363
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number402451
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number467404-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: