Provider Demographics
NPI:1164567756
Name:FOREST HILLS PEDIATRICS LLP
Entity Type:Organization
Organization Name:FOREST HILLS PEDIATRICS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NONNA
Authorized Official - Middle Name:B
Authorized Official - Last Name:RIVKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-263-2072
Mailing Address - Street 1:10848 70TH ROAD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375
Mailing Address - Country:US
Mailing Address - Phone:718-263-2072
Mailing Address - Fax:718-261-9082
Practice Address - Street 1:10848 70TH ROAD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:718-263-2072
Practice Address - Fax:718-261-9082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082603208000000X
NY086487208000000X
NY143693208000000X
NY204305208000000X
NY209494208000000X
NY208718208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty