DR. ELI MICHAEL SIMONG FORMAN PHD NPI 1033218714

NPI Information

NPI: 1033218714
Provider Name: DR. ELI MICHAEL SIMONG FORMAN, PHD
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
431 PARK AVENUE
LEONIA, NJ
ZIP 07605
Phone: (201) 592-7388
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DR. Eli Michael Simong Forman, PHD is a mental health counselor in Leonia, NJ. DR. Eli Michael Simong Forman, PHD NPI is 1033218714. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

431 PARK AVENUE
LEONIA, NJ
ZIP 07605-219
Phone: (201) 592-7388
Fax: (201) 592-6301

The enumeration date for this NPI number is 9/21/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	5688633	NEW YORK	Yes
2	101YP2500X	Counselor	Professional	0019	MARYLAND	X
3	106H00000X	Marriage & Family Therapist		M038	MARYLAND	X
4	106H00000X	Marriage & Family Therapist		MFC13681	CALIFORNIA	X
5	106H00000X	Marriage & Family Therapist		37F100059900	NEW JERSEY	X

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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