Marie Diane Forman, LDO
Technician/Technologist, Optician in Geneseo, NY. Individual provider (NPI-1).
NPI number1740035294
StatusActive
Last updated in NPPESApr 18, 2024
Details
- NPI
- 1740035294
- Entity type
- Individual (NPI-1)
- Name
- Ms. Marie Diane Forman
- Credential
- LDO
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 18, 2024
- Certification date
- Apr 18, 2024
- Last updated
- Apr 18, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- 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 |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | 01035-01 | NY | Yes |
Practice location
4235 Veteran DrGeneseo, NY 14454-9442
Phone 585-243-4004 · Fax 585-243-4009
Mailing address
4235 Veteran DrGeneseo, NY 14454-9442
Phone 585-243-4004 · Fax 585-243-4009
Is something wrong?
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Other Optician providers in Geneseo, NY
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