Individual
DR. DAMIAN FORLETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
815 HALLOCK AVE, SUITE A, PORT JEFFERSON STATION, NY 11776-1244
(631) 331-7267
Mailing address
PO BOX 1559, STONY BROOK, NY 11790
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
164113
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000059056
GHI HMO ID
NY
05
—
01082773
—
NY
01
—
164113
HIP
NY
01
—
1807144003
CIGNA ID
NY
01
—
2600579
GHI PPO ID
NY
01
—
2787
VYTRA ID
NY
01
—
4061141
AETNA NON-HMO ID
NY
01
—
5B780
EMPIRE BC/BS
NY
01
—
877643
AETNA HMO ID
NY
01
—
CP103
OXFORD ID
NY
01
—
O85640
UNITED HEALTH CARE
NY
01
—
OC9245
PHS / HEALTH NET
NY
Enumeration date
02/28/2006
Last updated
09/19/2017
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