Provider Demographics
NPI:1790863587
Name:FORREST, ROY C (MD)
Entity type:Individual
Prefix:DR
First Name:ROY
Middle Name:C
Last Name:FORREST
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 AVENUE OF THE AMERICAS FL 8
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10105-0018
Mailing Address - Country:US
Mailing Address - Phone:908-588-3635
Mailing Address - Fax:908-934-9350
Practice Address - Street 1:171 HUGUENOT ST
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-7760
Practice Address - Country:US
Practice Address - Phone:914-682-6532
Practice Address - Fax:914-681-5260
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217522207R00000X
FLME139149207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAM479ZMedicare PIN
00A729521Medicare ID - Type Unspecified
CA00A729520Medicaid
CAAM479ZMedicare PIN
H33762Medicare UPIN