MR. SAMUEL AUSTIN FORMANEK


Address: 248 W 108th St, New York, NY 10025-2956
Phone: 2126633000

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YM0800X Counselor
Specialization: Mental Health
P107181 NY Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
NY P107181 05
NY NY STATE LICENSE PERMIT P107181 01

Office Location

Street Address 248 W 108TH ST
City NEW YORK
State NY
Zip Code 10025-2956

Providers in the same location

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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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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
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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1063013191 Clinicians of The Diaspora, LLC Counselor 203 W 117th St Apt 3e, New York, NY 10026-2139 2020-11-04
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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Competitor

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City NEW YORK
Zip Code 10025

Improve Information

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Dataset Information

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.

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