Healthcare Provider Details

I. General information

NPI: 1760397715
Provider Name (Legal Business Name): LEIGHTON LLOYD FOSTER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 OLIVIA ST
DERBY CT
06418-1528
US

IV. Provider business mailing address

320 OLIVIA ST
DERBY CT
06418-1528
US

V. Phone/Fax

Practice location:
  • Phone: 914-258-4810
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number227553
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: