Provider Demographics
NPI:1285695957
Name:FOSTER, DAVID (RPA-C)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:FOSTER
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 EXECUTIVE PARK DR
Mailing Address - Street 2:2ND FL
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-3700
Mailing Address - Country:US
Mailing Address - Phone:518-482-8631
Mailing Address - Fax:518-482-0173
Practice Address - Street 1:2 EXECUTIVE PARK DR
Practice Address - Street 2:2ND FL
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-1220
Practice Address - Country:US
Practice Address - Phone:518-482-8631
Practice Address - Fax:518-482-0173
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005225-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY318709OtherMVP PROVIDER NUMBER
NYP48369Medicare UPIN
NYDD0375Medicare PIN