Eli Michael Simong Forman PHD

NPI 1033218714 - Counselor - 101YM0800X

NPI Details
NPI 1033218714
Gender Male
Enumeration Date 09/21/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
431 PARK AVENUE
LEONIA NJ, 07605-1219, US
Phone (201) 592-7388
Fax (201) 592-6301
Business Location
431 PARK AVENUE
LEONIA NJ, 07605-1219, US
Phone (201) 592-7388
Fax (201) 592-6301
Toxanomy
Taxonomy Code 101YM0800X
License State New York
License Number 5688633
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According to our database, Dr. Eli Michael Simong Forman PHD NPI is 1033218714, taxonomy code is 101YM0800X and license number is 5688633, license state is located at New York. Eli Michael Simong Forman PHD physically located at 431 Park Avenue, Leonia NJ, 07605-1219. NPI Number Eli Michael Simong Forman PHD has the Individual type.

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1033218714 NPI number is provided on an as is basis without warranty of any kind. 1033218714 is maintained by the National Plan & Provider Enumeration System. The contents of Eli Michael Simong Forman PHD are for informational purposes only.