Provider Demographics
NPI:1083005797
Name:FOREST HILLS AUDIOLOGY PC
Entity Type:Organization
Organization Name:FOREST HILLS AUDIOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADIOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROKSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORUKHOVA
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:347-409-8958
Mailing Address - Street 1:11011 72ND AVE
Mailing Address - Street 2:STE 1B
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4910
Mailing Address - Country:US
Mailing Address - Phone:718-577-2235
Mailing Address - Fax:347-229-9000
Practice Address - Street 1:11011 72ND AVE
Practice Address - Street 2:STE 1B
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4910
Practice Address - Country:US
Practice Address - Phone:718-577-2235
Practice Address - Fax:347-229-9000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-17
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002511-1237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty