Basic Information
Provider Information
NPI: 1285635441
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FORBES
FirstName: FLOYD
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 68 S SERVICE RD
Address2: SUITE 350
City: MELVILLE
State: NY
PostalCode: 117472354
CountryCode: US
TelephoneNumber: 5169453000
FaxNumber:  
Practice Location
Address1: 270 PARK AVE
Address2: ANESTHESIA DEPARTMENT
City: HUNTINGTON
State: NY
PostalCode: 117432787
CountryCode: US
TelephoneNumber: 6313512785
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/09/2005
LastUpdateDate: 10/05/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X135566NYY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
0078740805NY MEDICAID


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