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Organization
FOREST MEDCARE P.C.
Active
Organization
FOREST MEDCARE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERZY WAWERSKI M.D. (MEDICAL DOCTOR)
(718) 381-3766
Entity
Organization
Contact information
Practice address
6050 69TH AVE, GROUND FLOOR, RIDGEWOOD, NY 11385-5140
(718) 381-3766
(718) 381-3765
Mailing address
6657 FOREST AVE, GROUND FLOOR, RIDGEWOOD, NY 11385-3837
(718) 381-3766
(718) 381-3765
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
204587
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02131684
—
NY
01
—
06979A
MEDICARE PTAN
NY
Enumeration date
11/10/2006
Last updated
06/13/2008
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