National Provider Identifier
Marie Diane Forman, LDO
Marie Diane Forman, LDO is listed in the NPPES registry with a primary specialty of Optician in Geneseo, NY and a listed phone number of (585) 243-4004.
Profile Overview
- NPI
- 1740035294
- Provider Type
- Individual
- Primary Specialty
- Optician
- Enumeration Date
- April 18, 2024
- Last Updated
- April 18, 2024
Practice Location
- 4235 Veteran Dr
- Geneseo, NY 14454-9442
Phone: (585) 243-4004
Specialties
- Optician (156FX1800X)
Full Record
- NPI
- 1740035294
- Entity Type
- Individual
- Last Name
- Forman
- First Name
- Marie
- Middle Name
- Diane
- Name Prefix
- MS.
- Credential
- LDO
- Mailing Street Address
- 4235 Veteran Dr
- Mailing City
- Geneseo
- Mailing State
- NY
- Mailing ZIP Code
- 14454-9442
- Mailing Country
- US
- Mailing Phone
- (585) 243-4004
- Mailing Fax
- (585) 243-4009
- Practice Street Address
- 4235 Veteran Dr
- Practice City
- Geneseo
- Practice State
- NY
- Practice ZIP Code
- 14454-9442
- Practice Country
- US
- Practice Phone
- (585) 243-4004
- Practice Fax
- (585) 243-4009
- Enumeration Date
- April 18, 2024
- Last Updated
- April 18, 2024
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- April 18, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Optician (156FX1800X)