Organization
FORESTREAM PEDIATRICS, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY PRISE M.D. (PRESIDENT)
(716) 668-5331
Entity
Organization
Contact information
Practice address
4711 TRANSIT RD, SUITE1, DEPEW, NY 14043-4888
(716) 668-5331
(716) 668-5370
Mailing address
4711 TRANSIT RD, SUITE1, DEPEW, NY 14043-4888
(716) 668-5331
(716) 668-5370
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02366498
—
NY
Enumeration date
04/27/2006
Last updated
09/09/2014
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