Provider Demographics
NPI:1508397738
Name:NORTHSHORE LIJ FOREST HILLS
Entity Type:Organization
Organization Name:NORTHSHORE LIJ FOREST HILLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KISHENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOPAUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-475-4598
Mailing Address - Street 1:10102 STANSFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-1738
Mailing Address - Country:US
Mailing Address - Phone:240-475-4598
Mailing Address - Fax:
Practice Address - Street 1:10102 STANSFIELD RD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-1738
Practice Address - Country:US
Practice Address - Phone:240-475-4598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital