FOREVER YOUNG MEDICAL SERVICES P.A.
NPI 1215617402
Clinic/Center in White Plains, NY

Q: What is Forever Young Medical Services P.A.'s NPI number?

The NPI number for Forever Young Medical Services P.A. is 1215617402. It was assigned to this organization in the NPPES registry on July 21, 2023. The provider is also known as Fountain Life NY.

Q: What is Forever Young Medical Services P.A.'s specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Active since July 21, 2023

4 WESTCHESTER PARK DR STE 200, WHITE PLAINS, NY 10604(914) 810-6621 Get Directions Write a Review

NPPES record last updated: July 21, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Forever Young Medical Services P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FOREVER YOUNG MEDICAL SERVICES P.A. (NPI 1215617402) is a healthcare organization registered as a clinic/center in White Plains, New York and active in the NPI registry since July 2023. The organization lists Barbara Woo, Director Of Clinical Operations, as its authorized official.

NPPES Registry Identity

NPI1215617402

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameFOREVER YOUNG MEDICAL SERVICES P.A.

Location Address4 WESTCHESTER PARK DR STE 200White Plains, NY 10604-3431

Mailing Address4 Westchester Park Dr Ste 200White Plains, NY 10604-3431 · (914) 810-6621

Phone(914) 810-6621

Organization SubpartNo

Authorized OfficialBarbara WooDirector Of Clinical Operations · (917) 810-8672

Enumeration DateJuly 21, 2023

NPPES CertifiedJuly 21, 2023

✔ NPI 1215617402 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

4 WESTCHESTER PARK DR STE 200, White Plains, NY 10604

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Other Names 1

Other NameFountain Life Ny

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. NICOLE SASHANNA ARVIDSON AGNP- BC, MSN

Nurse Practitioner (Adult Health)

4 WESTCHESTER PARK DR STE 200
WHITE PLAINS, NY 10604

Westchester County (914) 837-1997

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Forever Young Medical Services P.A.'s NPI number?

The NPI number for Forever Young Medical Services P.A. is 1215617402. It was assigned to this organization in the NPPES registry on July 21, 2023. The provider is also known as Fountain Life NY.

Where is Forever Young Medical Services P.A. located?

Forever Young Medical Services P.A. is located at 4 Westchester Park Dr Ste 200, White Plains, NY 10604. The listed phone number is (914) 810-6621.

What is Forever Young Medical Services P.A.'s specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Forever Young Medical Services P.A. was last updated on July 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.