Provider Demographics
NPI:1245385103
Name:FORLINI, ROSEMARY (LPN)
Entity Type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:
Last Name:FORLINI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:ROSEMARY
Other - Middle Name:
Other - Last Name:DEMARCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:25 WESTBROOK RD
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-1015
Mailing Address - Country:US
Mailing Address - Phone:516-848-8378
Mailing Address - Fax:
Practice Address - Street 1:25 WESTBROOK RD
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-1015
Practice Address - Country:US
Practice Address - Phone:516-848-8378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY201835-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01948943Medicaid