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NPI Code Detail

MEDICARE: DR. FRIMMIT L FORMAN M.D.

MEDICARE: DR. FRIMMIT L FORMAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician168368NY

General Provider Information

NPI Number : 1902806425
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FRIMMIT L FORMAN M.D.
Provider Business Mailing Address
First Line : 1 GUSTAVE L. LEVY PLACE
Second Line : BOX 1194
City : NEW YORK
State : NY
Zip : 10029-6574
Country : US
Telephone Number : 212-241-8395
Fax Number : 212-289-0092
Provider Business Practice Location Address
First Line : 3201 KINGS HWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-2625
Country : US
Telephone Number : 718-951-2930
Fax Number : 718-951-2727
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2005
Last Update Date : 01/07/2015

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