Individual
RICHARD A FORBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EMT
Contact information
Practice address
16 ADAMS LN, HAINESPORT, NJ 08036-2600
(609) 914-1700
Mailing address
16 ADAMS LN, HAINESPORT, NJ 08036-2600
(609) 914-1700
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
530134
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
530134
NJ DEPT OF HEALTH & SENIOR SERVICES
NJ
Enumeration date
12/14/2010
Last updated
12/14/2010
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