NPIMap

Organization Active NPI

Forever Young Medical Services P.a.

  • Clinic/Center
  • White Plains, NY
National Provider Identifier
1215617402
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
FOREVER YOUNG MEDICAL SERVICES P.A.
Practice address
4 Westchester Park Dr Ste 200
White Plains, NY 10604-3431
Phone
(914) 810-6621
NPI assigned
Jul 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Barbara Woo
Title
Director of Clinical Operations
Phone
(917) 810-8672

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

4 Westchester Park Dr Ste 200
White Plains, NY 10604-3431

Mailing address

4 Westchester Park Dr Ste 200
White Plains, NY 10604-3431
Phone (914) 810-6621

Other names 1

  • Fountain Life NY Other name

National Provider Directory

National Provider Directory

Locations

4 Westchester Park Dr
Ste 200
White Plains, NY 10604
Phone (914) 810-6621

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689897600000",
    "number": "1215617402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WESTCHESTER PARK DR STE 200",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106043431",
            "telephone_number": "914-810-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WESTCHESTER PARK DR STE 200",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106043431",
            "telephone_number": "914-810-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREVER YOUNG MEDICAL SERVICES P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-21",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A",
        "authorized_official_last_name": "WOO",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "917-810-8672"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fountain Life NY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.