Provider Demographics
NPI:1164950549
Name:FORSTER, DENISE (LAC, CNS, CDN)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:FORSTER
Suffix:
Gender:F
Credentials:LAC, CNS, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 E SHORE RD STE 305
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-2432
Mailing Address - Country:US
Mailing Address - Phone:516-466-1045
Mailing Address - Fax:
Practice Address - Street 1:310 E SHORE RD STE 305
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-2432
Practice Address - Country:US
Practice Address - Phone:516-466-1045
Practice Address - Fax:516-466-7069
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-30
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001557171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist