Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MARISA FORMICA, MD
ActiveMARISA FORMICA, MD is a Sports Medicine healthcare provider located in GLEN COVE, New York. NPI 1568759041 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine · GLEN COVE, NY
Registration Details
- NPI Number
- 1568759041
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 5, 2011 (15.080232922766 yrs)
- Last Updated
- Jan 16, 2026
- Licenses
-
280850 (NY)280850 (NY)
Practice Information
- Address
-
101 SAINT ANDREWS LNGLEN COVE, NY, 115422254Browse NY providers · Browse ZIP 11542
- Phone
- 5166747631
- Primary Specialty
-
Sports Medicine
207QS0010X
- Additional Specialty
- Sports Medicine
- Additional Specialty
- Student (Health Education/Training)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.