Provider Demographics
NPI:1316990435
Name:FOSTER, RICHARD MILTON (DPM)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:MILTON
Last Name:FOSTER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 ESSEX STREET
Mailing Address - Street 2:SUITE 106
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601
Mailing Address - Country:US
Mailing Address - Phone:201-646-1406
Mailing Address - Fax:201-646-1053
Practice Address - Street 1:211 ESSEX STREET
Practice Address - Street 2:SUITE 106
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601
Practice Address - Country:US
Practice Address - Phone:201-646-1406
Practice Address - Fax:201-646-1053
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD001449213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT45526Medicare UPIN
NJFO456450Medicare ID - Type Unspecified