MEDICARE: FOREFRONT BEHAVIORAL MEDICINE, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1558874586
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOREFRONT BEHAVIORAL MEDICINE, P.C.

Provider Business Mailing Address
First Line	:	1717 MAIN ST STE 5850
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-7317
Country	:	US
Telephone Number	:	866-959-2008
Fax Number	:	888-972-2903

Provider Business Practice Location Address
First Line	:	26 COURT ST STE 502
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11242-1105
Country	:	US
Telephone Number	:	917-342-2680
Fax Number	:	888-506-8293

Authorized Official
Title or Position	:	OWNER
Name	:	JOSEPH B HOLMGREN
Credential	:	MD
Telephone Number	:	917-342-2680

Provider Enumeration Date	:	11/13/2017
Last Update Date	:	10/18/2024

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