1922075217 NPI number — MARGARITA M. FORBATH LCSW-R

Table of content: MARGARITA M. FORBATH LCSW-R (NPI 1922075217)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922075217 NPI number — MARGARITA M. FORBATH LCSW-R

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FORBATH
Provider First Name:
MARGARITA
Provider Middle Name:
M.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW-R
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MORGADO
Provider Other First Name:
MARGARITA
Provider Other Middle Name:
D.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW-R
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1922075217
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/16/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
686 KOELBEL CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALDWIN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11510-3914
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-546-0569
Provider Business Mailing Address Fax Number:
516-546-9824

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
686 KOELBEL CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALDWIN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11510-3914
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-546-0569
Provider Business Practice Location Address Fax Number:
516-546-9824
Provider Enumeration Date:
03/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  R028688-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7352096 . This is a "GHI PROVIDER NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P3106483 . This is a "OXFORD PROVIDER ID NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000009404875 . This is a "PHCS PROVIDER NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 354762P . This is a "HIP-HEALTH PLAN OF NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 9542EC . This is a "GHI MEDICARE PTAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: IP568045 . This is a "MAGELLAN INDV PROVIDER NO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: IPD284025000 . This is a "INTEGRATED PROV DATABASE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2826093000 . This is a "AMERIHEALTH PROVIDER ID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7197342 . This is a "AETNA PROVIDER ID NO/PIN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: A26820 . This is a "1199 SEIU BENEFIT FUND" identifier . This identifiers is of the category "OTHER".
  • Identifier: 556866 . This is a "VALUE OPTIONS PROVIDER NO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 11567232 . This is a "CAQH PROVIDER ID" identifier . This identifiers is of the category "OTHER".




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