Provider Demographics
NPI:1114928413
Name:FORLANO, WILLIAM H (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
Last Name:FORLANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 HOLLAND CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-7550
Mailing Address - Country:US
Mailing Address - Phone:518-843-4522
Mailing Address - Fax:518-843-8306
Practice Address - Street 1:119 HOLLAND CIRCLE DR
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-7550
Practice Address - Country:US
Practice Address - Phone:518-843-4522
Practice Address - Fax:518-843-4522
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228576207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02426593Medicaid
NYDD6395Medicare PIN
NYH89826Medicare UPIN