Bonnie Forman

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

009166-1 Issued in NY

Practice address

315 Bliss LN
Valley Cottage, NY 10989-2421

Phone

(516) 851-2957

NPI assigned

Jan 25, 2008

Last updated

Jan 25, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fox Rehabilitation Physical Therapy Services LLC

  • Physical Therapist
  • New York, NY
  • NPI 1174560650

  Speech-Language Pathologist

  Medicare reassignment NPD

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201219200000",
    "number": "1770760456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 BLISS LN",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 BLISS LN",
            "city": "VALLEY COTTAGE",
            "state": "NY",
            "postal_code": "109892421",
            "telephone_number": "516-851-2957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "BONNIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-25",
        "last_updated": "2008-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "009166-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Farris, OTR/L
• Megan Elizabeth Fay, LPN
• Brianne Fegarsky, LMSW, CASAC-T
• Heather Fierman
• Kathleen Finn, PSY.D.
• Edwin Fortere
• Denise Foster, PH.D.
• Jessica Francois
• Freedom Center of Rockland County, LLC (Fresenius Kidney Care Valley Cottage)
• Wesal Y Freih, PHARM.D

• Speech-Language Pathologist in Valley Cottage, NY
• Providers in Valley Cottage, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.