Individual
MR. DANIEL GLENN FORSBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
1044 NORTHERN BLVD, SUITE 302, ROSLYN, NY 11576-1514
(516) 621-1313
(516) 621-0116
Mailing address
1345 RXR PLZ, UNIONDALE, NY 11556-1301
(516) 453-0435
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
003030
NY
363AS0400X
Surgical Physician Assistant
Primary
003030
NY
Other
Enumeration date
10/11/2006
Last updated
04/24/2019
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