Basic Information
| Provider Information | |||||||||
| NPI: | 1225191604 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FOREST HILLS MEDICAL ASSOCIATES, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10828 68TH DR | ||||||||
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| City: | FOREST HILLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113752951 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182619245 | ||||||||
| FaxNumber: | 7182619247 | ||||||||
| Practice Location | |||||||||
| Address1: | 18811 HILLSIDE AVE | ||||||||
| Address2: | |||||||||
| City: | HOLLIS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114231935 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182646703 | ||||||||
| FaxNumber: | 7182646833 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | KIM | ||||||||
| AuthorizedOfficialFirstName: | YOUNG | ||||||||
| AuthorizedOfficialMiddleName: | I | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7182619245 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.