Individual
MRS. BARBARA STEPHANIE FORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
9 VICTORIA DR, AMITYVILLE, NY 11701-3807
(631) 691-0655
(631) 691-0655
Mailing address
9 VICTORIA DR, AMITYVILLE, NY 11701-3807
(631) 691-0655
(631) 691-0655
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
NY
Other
Enumeration date
02/02/2007
Last updated
07/25/2007
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