MEDICARE: MS. SUSAN ELIZABETH FOSTER MS PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT012468L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01858976 01	OTHER	PA	AMERICHOICE
2	1154160	OTHER	PA	KEYSTONE MERCY
3	2091653000	OTHER	PA	IBC HMO OUT OF NETWORK
4	2670221	OTHER	PA	USHEALTHCARE
5	2670221	OTHER	PA	AETNA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	18625PT012468L	OTHER	PA	HEALTH PARTNERS

General Provider Information

NPI Number	:	1598790982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN ELIZABETH FOSTER MS PT

Provider Business Mailing Address
First Line	:	111 ELWYN RD
Second Line	:	KIVITZ BLDG PHYS REHAB
City	:	ELWYN
State	:	PA
Zip	:	19063-4622
Country	:	US
Telephone Number	:	610-891-2656
Fax Number	:	610-891-2280

Provider Business Practice Location Address
First Line	:	111 ELWYN RD
Second Line	:	KIVITZ BLDG PHYS REHAB
City	:	ELWYN
State	:	PA
Zip	:	19063-4622
Country	:	US
Telephone Number	:	610-891-2656
Fax Number	:	610-891-2280

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	07/08/2007

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