MR. SAMUEL AUSTIN FORMANEK (NPI# 1811595259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1811595259 |
Entity Type | Individual |
Full Name | MR. SAMUEL AUSTIN FORMANEK |
Practice Address |
248 W 108th St New York NY 10025-2956 |
Mailing Address |
41 Corell Rd Scarsdale NY 10583-7448 |
Practice Telephone | 2126633000 |
Mailing Telephone | 1914844297 |
Enumeration Date | 2020-10-16 |
Last Update Date | 2020-10-16 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YM0800X |
Counselor Specialization: Mental Health |
P107181 | NY | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | P107181 | 05 | |
NY | NY STATE LICENSE PERMIT | P107181 | 01 |
Street Address |
248 W 108TH ST |
City | NEW YORK |
State | NY |
Zip Code | 10025-2956 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932279973 | Harriet O Hagan | Psychiatry & Neurology | 248 W 108th St, New York, NY 10025-2956 | 2006-11-08 |
1689284598 | Emily Thulier | Counselor | 248 W 108th St, New York, NY 10025-2956 | 2020-08-05 |
1184250474 | Jessica Mae Orense | Counselor | 248 W 108th St, New York, NY 10025-2956 | 2020-03-18 |
1871155903 | Marsha Avecita Noel | Licensed Practical Nurse | 248 W 108th St, New York, NY 10025-2956 | 2019-06-28 |
1821655564 | Elizabeth Connolly | Social Worker | 248 W 108th St, New York, NY 10025-2956 | 2019-05-28 |
1912564923 | Jessica O'neill | Social Worker | 248 W 108th St, New York, NY 10025-2956 | 2019-05-24 |
1346710753 | Emily Beyer | Counselor | 248 W 108th St, New York, NY 10025-2956 | 2018-11-28 |
1053800938 | Jamie Adorno | Registered Nurse | 248 W 108th St, New York, NY 10025-2956 | 2018-05-06 |
1083125181 | Elinatan C Weinstein | Social Worker | 248 W 108th St, New York, NY 10025-2956 | 2017-10-16 |
1689184301 | Liesl Glover | Social Worker | 248 W 108th St, New York, NY 10025-2956 | 2017-10-08 |
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1730795840 | Third Eye Acupuncture P.C. | Acupuncturist | 255 West 94th Street, Apt. 6k, New York, NY 10025 | 2020-09-23 |
1326653882 | Clare Elizabeth Dacey | Social Worker | 251 West 98th Street, Apartment 6-b, New York, NY 10025 | 2020-09-11 |
1528672870 | Alexandra E Lamm | Psychologist | 50 W 96th Street, Apt 5a-d, New York, NY 10025 | 2020-09-03 |
1700402310 | Jean Tully | Counselor | 240 W102nd St., #22a, New York, NY 10025 | 2020-06-19 |
1518591692 | Ethan Arthur Baker | Acupuncturist | 309 W. 99th St., Apt. 8b, New York City, NY 10025 | 2020-02-27 |
1083258321 | Lisanne Godnick | Social Worker | 210 W 101 St, Nyc, NY 10025 | 2019-10-30 |
1558910463 | Cherry Jones | Social Worker | 440 W 114th Street, Clark 6, New York, NY 10025 | 2019-09-04 |
1245894674 | Westside Nutrition Pllc | Dietitian, Registered | 240 West 102nd Street, Suite 15, New York, NY 10025 | 2019-05-01 |
1518429380 | Nathan Yehuda Ben Agi | Student in an Organized Health Care Education/Training Program | Mt. Sinai St. Lukes, 1111 Amsterdam Avenue, New York, NY 10025 | 2019-04-02 |
1366913196 | Mavis H Baird | Counselor | 243 W 99th St #3e, New York, NY 10025 | 2018-12-05 |
Find all providers in zip 10025 |
Taxonomy Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
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---|---|---|---|---|
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1730789389 | Willam Bernard Feehan | Counselor | 14 Sutton Pl S Apt 3b, New York, NY 10022-3109 | 2020-10-31 |
1316547029 | Erica Marie Mclaughlin | Counselor | 109 E. 115th Street, New York, NY 10029 | 2020-10-30 |
1801496237 | Vivian Martinez | Counselor | 200 W 108th St Apt 3f, New York, NY 10025-2947 | 2020-10-26 |
1124627989 | Sable Tempest Sweeper | Counselor | 31 West 34th Street, 7th Floor #7058, New York, NY 10001 | 2020-10-22 |
1083213144 | Isaiah David Putman | Counselor | 236 W 64th St Apt 2h, New York, NY 10023-6433 | 2020-10-20 |
1790383826 | Iris M Canales | Counselor | Gusatave L Levy Place, Mount Sinai Hospital, New York, NY 10029-6574 | 2020-10-12 |
1508463860 | Marley S Moreira-rivera | Counselor | 2578 Broadway # 507, New York, NY 10025-5642 | 2020-10-08 |
1629675194 | Colombage Asha De Costa | Counselor | 106 Fort Washington Ave Apt 3k, New York, NY 10032-4723 | 2020-10-07 |
1497352603 | Arlene Pineda | Counselor | 303 5th Ave Fl 14, New York, NY 10016-6601 | 2020-10-01 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.