Forest Hills Surgical Associates PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

136142 Issued in NY

Legal business name

FOREST HILLS SURGICAL ASSOCIATES PC

Doing business as

FOREST HILLS SURGICAL ASSOCIATES PC

Practice address

11042 72ND Rd
Forest Hills, NY 11375-8303

Phone

(718) 544-0918

Fax

(718) 544-0919

NPI assigned

Mar 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Manuel A Fajardo, MD

Title

President

Phone

(718) 544-0918

Specialties & licenses 1

Addresses

Other names 1

• FOREST HILLS SURGICAL ASSOCIATES PC Doing business as

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

{
    "created_epoch": "1173484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912039405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11042 72ND RD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113758303",
            "telephone_number": "718-544-0918",
            "fax_number": "718-544-0919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11042 72ND RD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113758303",
            "telephone_number": "718-544-0918",
            "fax_number": "718-544-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST HILLS SURGICAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FAJARDO",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-544-0918",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "136142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOREST HILLS SURGICAL ASSOCIATES PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Surgery Physician in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.