Healthcare Provider Details

I. General information

NPI: 1578190468
Provider Name (Legal Business Name): JOHN P FORRESTER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2020
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 LYONS AVE
NEWARK NJ
07112-2027
US

IV. Provider business mailing address

201 LYONS AVE
NEWARK NJ
07112-2027
US

V. Phone/Fax

Practice location:
  • Phone: 973-926-7000
  • Fax:
Mailing address:
  • Phone: 973-926-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XC2901X
TaxonomyCardiovascular Invasive Specialist/Technologist
License Number25MB13085900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number321255
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: