Provider Demographics
NPI:1225191604
Name:FOREST HILLS MEDICAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:FOREST HILLS MEDICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUNG
Authorized Official - Middle Name:I
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-261-9245
Mailing Address - Street 1:10828 68TH DR
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2951
Mailing Address - Country:US
Mailing Address - Phone:718-261-9245
Mailing Address - Fax:718-261-9247
Practice Address - Street 1:18811 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-1935
Practice Address - Country:US
Practice Address - Phone:718-264-6703
Practice Address - Fax:718-264-6833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY71510Medicare ID - Type UnspecifiedANESTHESIA GROUP