# FOREST HILL FAMILY HEALTH ASSOCIATES P A

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134292360
- **Authorized official:** THOMAS R ORTIZ MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (973) 485-6242

## Contact information

- **Practice address:** 465 MT. PROSPECT AVENUE, NEWARK, NJ 07104
- **Practice address phone:** (973) 483-3640
- **Practice address fax:** (973) 483-0132
- **Mailing address:** 465 MT. PROSPECT AVENUE, NEWARK, NJ 07104
- **Mailing address phone:** (973) 483-3640
- **Mailing address fax:** (973) 483-0132

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/16/2006
- **Last updated:** 04/30/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 033691BXB | MEDICARE GROUP SUFFIX | NJ |
| 01 | — | 1259202 | MEDICAID INDIVIDUAL PROVIDER | NJ |
| 05 | — | 3145107 | — | NJ |