Healthcare Provider Details

I. General information

NPI: 1316044910
Provider Name (Legal Business Name): FOREST HILLS ORTHOPEDIC GROUP P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2006
Last Update Date: 01/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6967 108TH STREET
FOREST HILLS NY
11375
US

IV. Provider business mailing address

69-67 108TH STREET
FOREST HILLS NY
11375-3846
US

V. Phone/Fax

Practice location:
  • Phone: 718-268-4938
  • Fax: 718-268-2963
Mailing address:
  • Phone: 718-268-4938
  • Fax: 718-268-2963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT DONADT
Title or Position: PRESIDENT
Credential: MD
Phone: 718-268-4938