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Organization
FS PHYSICIAN MEDICAL
Active
Organization
FS PHYSICIAN MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY FERSTENBERG M.D. (CEO)
(516) 972-2215
Entity
Organization
Contact information
Practice address
203 BIRCH DR, NEW HYDE PARK, NY 11040-2346
(516) 972-2215
Mailing address
461 PARK AVE S, 11TH FLOOR, NEW YORK, NY 10016-6822
(212) 473-6500
(212) 529-3016
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
139924
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139924
LICENSE
NY
01
—
176352
SHELBY SAMUEL LICENSE
NY
Enumeration date
09/25/2009
Last updated
09/25/2009
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