Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 202039 | NY |
NPI | 1073699344 |
---|---|
Provider Name | Rene J Forti |
First Address | Roslyn, NY 11576-3127 |
Second Address | Bronx, NY 10467 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2006 |
Last Update Date | 08/07/2007 |