Individual provider Active NPI

Victoria Rose Formosa, LMSW

  • Social Worker
  • New York, NY
National Provider Identifier
1346697968
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
72095800 Issued in NY
Practice address
230 W 17TH St
New York, NY 10011-5325
Phone
(212) 271-7177
NPI assigned
May 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 72095800 NY Primary

Addresses

Primary practice location

230 W 17TH St
New York, NY 10011-5325

Mailing address

230 W 17TH St
New York, NY 10011-5325
Phone (212) 271-7177

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
72095800NYMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1346697968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 W 17TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100115325",
            "telephone_number": "212-271-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W 17TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100115325",
            "telephone_number": "212-271-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMOSA",
        "first_name": "VICTORIA",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-24",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "72095800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.