Evan Alexander Formosa

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

40 Sunshine Cottege Road
New York Medical College Student Affairs Suite 122a
Valhalla, NY 10595

Phone

(914) 594-4498

Fax

(914) 594-4613

NPI assigned

Feb 18, 2020

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1871126946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 SUNSHINE COTTEGE ROAD",
            "address_2": "NEW YORK MEDICAL COLLEGE STUDENT AFFAIRS SUITE 122A",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "10595",
            "telephone_number": "914-594-4498",
            "fax_number": "914-594-4613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SUNSHINE COTTEGE ROAD",
            "address_2": "NEW YORK MEDICAL COLLEGE STUDENT AFFAIRS SUITE 122A",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "10595",
            "telephone_number": "914-594-4498",
            "fax_number": "914-594-4613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMOSA",
        "first_name": "EVAN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Franceska Floriant
• Jean Marie Florkowski, OTR
• Brianne Eileen Flynn, PA-C
• Jhenelle Forbes, CRNA
• Leanne Michelle Forman, MD
• Christeena Forte
• Irene Fosu-Apraku, MD
• Karen Francois, MD
• Kristjana Frangaj, MD
• Michael Frankenthaler, M.D.

• Student in an Organized Health Care Education/Training Program in Valhalla, NY
• Providers in Valhalla, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.