Provider Demographics
NPI:1811561855
Name:FORGE MEDICAL GROUP, LLC
Entity Type:Organization
Organization Name:FORGE MEDICAL GROUP, LLC
Other - Org Name:FORGE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LENZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-709-6883
Mailing Address - Street 1:10 BANK ST STE 830
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-1952
Mailing Address - Country:US
Mailing Address - Phone:646-709-6883
Mailing Address - Fax:
Practice Address - Street 1:1133 WESTCHESTER AVE STE N-006
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-3550
Practice Address - Country:US
Practice Address - Phone:914-539-7600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-14
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty