# SCOTT FORMAN, MD PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SCOTT
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1366975690
- **Legal business name:** SCOTT
- **Authorized official:** VERONICA CRUZ (OFFICE MANAGER)
- **Authorized official phone:** (914) 277-5550

## Contact information

- **Practice address:** 380 ROUTE 202, SOMERS, NY 10589-3222
- **Practice address phone:** (914) 277-5550
- **Practice address fax:** (914) 277-5735
- **Mailing address:** 380 ROUTE 202, SOMERS, NY 10589-3222
- **Mailing address phone:** (914) 277-5550
- **Mailing address fax:** (914) 277-5735

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 155754-1 | NY | Yes |

## Other

- **Enumeration date:** 04/04/2017
- **Last updated:** 04/04/2017