Basic Information
Provider Information | |||||||||
NPI: | 1316954449 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | FOREST HILLS HOSPITAL | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 972 BRUSH HOLLOW RD | ||||||||
Address2: | 5TH FLOOR FINANCE ATTN: WILLIAM J. FUCHS | ||||||||
City: | WESTBURY | ||||||||
State: | NY | ||||||||
PostalCode: | 115901740 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5168766000 | ||||||||
FaxNumber: | 5168766600 | ||||||||
Practice Location | |||||||||
Address1: | 102-66TH ROAD | ||||||||
Address2: |   | ||||||||
City: | FOREST HILLS | ||||||||
State: | NY | ||||||||
PostalCode: | 11375 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5168766000 | ||||||||
FaxNumber: | 5168766600 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 08/02/2006 | ||||||||
LastUpdateDate: | 12/03/2013 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | SHAPIRO | ||||||||
AuthorizedOfficialFirstName: | ROBERT | ||||||||
AuthorizedOfficialMiddleName: | S. | ||||||||
AuthorizedOfficialTitleorPosition: | SENIOR VICE PRESIDENT & CFO | ||||||||
AuthorizedOfficialTelephone: | 5164658162 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: | MR. | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 7003013H | NY | Y |   | Hospitals | General Acute Care Hospital |   |
No ID Information.