Individual
MR. CHARLES FORSBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
27005 76TH AVE, NEW HYDE PARK, NY 11040-1433
(718) 470-7501
Mailing address
27005 76TH AVE, NEW HYDE PARK, NY 11040-1433
(718) 470-7501
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004774
NY
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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