MEDICARE: FOREST HILLS SURGICAL CARE PLLC

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	2086S0129X	Vascular Surgery Physician

General Provider Information

NPI Number	:	1881087161
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOREST HILLS SURGICAL CARE PLLC

Provider Business Mailing Address
First Line	:	10810 72ND AVE
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-5338
Country	:	US
Telephone Number	:	718-261-4471
Fax Number	:

Provider Business Practice Location Address
First Line	:	10810 72ND AVE
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-5338
Country	:	US
Telephone Number	:	718-261-4471
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PHILIP LOPRESTI
Credential	:	D.D.
Telephone Number	:	718-261-4471

Provider Enumeration Date	:	03/11/2015
Last Update Date	:	03/11/2015

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