Provider Demographics
NPI:1790014470
Name:FORSBERG, JENNIFER M (RPA-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:FORSBERG
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Gender:F
Credentials:RPA-C
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Other - Middle Name:
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Mailing Address - Street 1:259 1ST ST
Mailing Address - Street 2:WINTHROP UNIVERSITY HOSPITAL
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3957
Mailing Address - Country:US
Mailing Address - Phone:516-663-2384
Mailing Address - Fax:516-663-8288
Practice Address - Street 1:259 1ST ST
Practice Address - Street 2:WINTHROP UNIVERSITY HOSPITAL
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3957
Practice Address - Country:US
Practice Address - Phone:516-663-2384
Practice Address - Fax:516-663-8288
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2021-04-01
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Provider Licenses
StateLicense IDTaxonomies
NY013572363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical