Provider Demographics
NPI:1003209339
Name:FORBES, PAMELA (RN)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:FORBES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11008 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-1342
Mailing Address - Country:US
Mailing Address - Phone:718-505-5110
Mailing Address - Fax:718-505-5115
Practice Address - Street 1:11008 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-1342
Practice Address - Country:US
Practice Address - Phone:718-505-5110
Practice Address - Fax:718-505-5115
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY550339163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse