Provider Demographics
NPI:1619674975
Name:FORBES, KINDELL D
Entity Type:Individual
Prefix:
First Name:KINDELL
Middle Name:D
Last Name:FORBES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 E 146TH ST APT 3C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10455-4238
Mailing Address - Country:US
Mailing Address - Phone:917-698-7500
Mailing Address - Fax:
Practice Address - Street 1:525 E 146TH ST APT 3C
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-4238
Practice Address - Country:US
Practice Address - Phone:917-698-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency