Katie Rae Forman, D.O.
Pediatrics, Neonatal-Perinatal Medicine in Bronx, NY. Individual provider (NPI-1).
NPI number1265664692
StatusActive
Last updated in NPPESJul 25, 2013
Details
- NPI
- 1265664692
- Entity type
- Individual (NPI-1)
- Name
- Katie Rae Forman
- Credential
- D.O.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 18, 2009
- Last updated
- Jul 25, 2013
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PEDIATRIC MEDICINE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080N0001X | Pediatrics, Neonatal-Perinatal Medicine | DO034307 | DC | Yes |
| 208000000X | Pediatrics | 251142 | NY |
Practice location
1601 Tenbroeck Ave2nd Floor
Bronx, NY 10461-2007
Phone 718-904-4105
Mailing address
1601 Tenbroeck Ave2nd Floor
Bronx, NY 10461-2007
Phone 718-904-4105
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Neonatal-Perinatal Medicine Physician providers in Bronx, NY
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All 29 Neonatal-Perinatal Medicine Physician providers in Bronx · All 38,045 providers in Bronx
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