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General NPI Number Information
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NPI Number | 1053628008
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Entity Type | Individual
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Provider Name | JILL M FOSTER L.P.N.
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Gender | Female
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Dates
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Enumeration Date | 09/10/2010
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Last Update Date | 02/05/2013
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Provider Practice Location Address
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Address Line | 27 PARK DRIVE APT 103
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City | PLEASANT VALLEY
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State | NY
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Zip | 12569-5304
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Country | US
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Telephone | 845-656-4128
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Fax |
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Provider Business Mailing Address
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Address Line | 27 PARK DR APT 103
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City | PLEASANT VALLEY
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State | NY
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Zip | 12569-6042
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Country | US
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Telephone | 845-656-4128
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 10273665
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License Number State | NY
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