Healthcare Provider Details

I. General information

NPI: 1790289650
Provider Name (Legal Business Name): LYNN ANN FORRESTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2018
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 WATERS PL FL 11
BRONX NY
10461-2733
US

IV. Provider business mailing address

1250 WATERS PL FL 11
BRONX NY
10461-2733
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-5976
  • Fax:
Mailing address:
  • Phone: 914-473-8946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number328726
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number328726
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: