Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Everett Roy Forman, MD

Individual provider General Practice Physician · NPI 1528061967

Everett Roy Forman, MD is a General Practice in Latham, New York. Graduated from Albany Medical College of Union University in 1968, 58 years ago. Accepts Medicare assignment. Licensed in New York.

Years since qualifying
58
Trained at
Albany Medical College of Union University
Licensed in
NY
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

585 Troy Schenectady Rd
Latham, NY 12110-2811
Phone: (518) 785-6004
Fax: (518) 785-1702
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence 103928-1 (NY)

Record details

NPI number1528061967
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 31, 2005
Last updated in NPPESJuly 8, 2007
Mailing address47 Sweet Rd, Ballston Lake, NY 12019-1805

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL PRACTICE
Medical schoolALBANY MEDICAL COLLEGE OF UNION UNIVERSITY
Graduated 1968 (58 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Latham