Healthcare Provider Details

I. General information

NPI: 1396951653
Provider Name (Legal Business Name): FOREST HEALTHCARE ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 FOREST AVENUE
PARAMUS NJ
07652
US

IV. Provider business mailing address

277 FOREST AVENUE
PARAMUS NJ
07652
US

V. Phone/Fax

Practice location:
  • Phone: 201-986-1016
  • Fax: 201-986-1871
Mailing address:
  • Phone: 201-986-1016
  • Fax: 201-986-1871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number311140
License Number StateNJ

VIII. Authorized Official

Name: DR. MOREY J. MENACKER
Title or Position: MEDICAL DIRECTOR
Credential: D.O.
Phone: 201-986-1881