NPIMap

Organization Active NPI

Forestdale, Inc.

  • Foster Care Agency
  • Forest Hills, NY
National Provider Identifier
1790803831
Registry record updated Dec 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
Legal business name
FORESTDALE, INC.
Practice address
67-35 112TH Street
Forest Hills, NY 11375
Phone
(718) 263-0740
Fax
(718) 263-8967
NPI assigned
Mar 27, 2007
Last updated
Dec 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2016

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

Authorized official

Name
Dr. William Weisberg, PHD
Title
Executive Director
Phone
(718) 263-0740

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X
Foster Care Agency 253J00000X Primary

Addresses

Primary practice location

67-35 112TH Street
Forest Hills, NY 11375

Mailing address

67-35 112TH Street
Forest Hills, NY 11375
Phone (718) 263-0740

Other identifiers 1

IdentifierTypeStateIssuer
00343320MedicaidNY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2051320Forestdale Inc67-35 112TH St - BLDG 3, Forest Hills, NY 11375Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Locations

6735 112th St
Forest Hills, NY 11375
Phone (718) 263-0740

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482883200000",
    "number": "1790803831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67-35 112TH STREET",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-263-0740",
            "fax_number": "718-263-8967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67-35 112TH STREET",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-263-0740",
            "fax_number": "718-263-8967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORESTDALE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2016-12-28",
        "status": "A",
        "authorized_official_last_name": "WEISBERG",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "718-263-0740",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00343320",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.