Healthcare Provider Details

I. General information

NPI: 1780513010
Provider Name (Legal Business Name): CARLY FOSTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10224 W 68TH WAY
ARVADA CO
80004-1513
US

IV. Provider business mailing address

10224 W 68TH WAY
ARVADA CO
80004-1513
US

V. Phone/Fax

Practice location:
  • Phone: 973-747-7272
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: