Healthcare Provider Details

I. General information

NPI: 1730098336
Provider Name (Legal Business Name): BRANDON FOSTER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: BRANDON ZACHARY AUSTIN JOHN- FOSTER

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11311 CLEMATIS BLVD
PITTSBURGH PA
15235-3152
US

IV. Provider business mailing address

11311 CLEMATIS BLVD
PITTSBURGH PA
15235-3152
US

V. Phone/Fax

Practice location:
  • Phone: 412-849-8217
  • Fax:
Mailing address:
  • Phone: 412-849-8217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP037010
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: