Healthcare Provider Details

I. General information

NPI: 1538333893
Provider Name (Legal Business Name): DAVID ALEXANDER FORSH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2008
Last Update Date: 07/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 E 98TH ST BOX 1188
NEW YORK NY
10029-6501
US

IV. Provider business mailing address

5 E 98TH ST BOX 1188
NEW YORK NY
10029-6501
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-1745
  • Fax:
Mailing address:
  • Phone: 212-241-1745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number247017
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberA116391
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number25MAO9157900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: