Healthcare Provider Details

I. General information

NPI: 1639132483
Provider Name (Legal Business Name): TERRENCE J FORSTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 10/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 TERRY DR SUITE 10A
NEWTOWN PA
18940-1838
US

IV. Provider business mailing address

4 TERRY DR SUITE 10A
NEWTOWN PA
18940-1838
US

V. Phone/Fax

Practice location:
  • Phone: 215-968-6000
  • Fax: 215-968-9287
Mailing address:
  • Phone: 215-968-6000
  • Fax: 215-968-9287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD033123E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207KI0005X
TaxonomyClinical & Laboratory Immunology (Allergy & Immunology) Physician
License NumberMD033123E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: