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Organization
FOREST HILL FAMILY HEALTH ASSOCIATES P A
Active
Organization
FOREST HILL FAMILY HEALTH ASSOCIATES P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS R ORTIZ MD (MEDICAL DIRECTOR)
(973) 485-6242
Entity
Organization
Contact information
Practice address
465 MT. PROSPECT AVENUE, NEWARK, NJ 07104
(973) 483-3640
(973) 483-0132
Mailing address
465 MT. PROSPECT AVENUE, NEWARK, NJ 07104
(973) 483-3640
(973) 483-0132
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033691BXB
MEDICARE GROUP SUFFIX
NJ
01
—
1259202
MEDICAID INDIVIDUAL PROVIDER
NJ
05
—
3145107
—
NJ
Enumeration date
11/16/2006
Last updated
04/30/2008
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