Provider Demographics
NPI:1912195546
Name:FORESTHILLS PHYSICAL THERAPY
Entity Type:Organization
Organization Name:FORESTHILLS PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FERN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOBACK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-526-4111
Mailing Address - Street 1:7050 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4737
Mailing Address - Country:US
Mailing Address - Phone:718-275-5108
Mailing Address - Fax:
Practice Address - Street 1:7050 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4737
Practice Address - Country:US
Practice Address - Phone:718-275-5108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006489225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty