Malka Leah Forman
Student in an Organized Health Care Education/Training Program in Boston, MA. Individual provider (NPI-1).
NPI number1013596477
StatusActive
Last updated in NPPESApr 5, 2021
Details
- NPI
- 1013596477
- Entity type
- Individual (NPI-1)
- Name
- Malka Leah Forman
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 5, 2021
- Certification date
- Apr 5, 2021
- Last updated
- Apr 5, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
145 Harrison AveBoston, MA 02111-1802
Phone 617-636-6568
Mailing address
145 Harrison AveBoston, MA 02111-1802
Phone 857-225-0576
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