Provider Demographics
NPI:1285997155
Name:FOSTER, COLLEEN M (MSED)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:M
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:RED HOOK
Mailing Address - State:NY
Mailing Address - Zip Code:12571-1542
Mailing Address - Country:US
Mailing Address - Phone:845-758-9704
Mailing Address - Fax:
Practice Address - Street 1:64 GARDEN ST
Practice Address - Street 2:
Practice Address - City:RED HOOK
Practice Address - State:NY
Practice Address - Zip Code:12571-1542
Practice Address - Country:US
Practice Address - Phone:845-758-9704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-16
Last Update Date:2012-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist