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General NPI Number Information
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NPI Number | 1174655518
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Entity Type | Individual
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Provider Name | FOSTER D MYERS III RPH
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Gender | Male
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 625 MADISON ST
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City | SYRACUSE
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State | NY
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Zip | 13210
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Country | US
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Telephone | 315-426-6836
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Fax | 315-426-6801
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Provider Business Mailing Address
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Address Line | 659 CROW HILL RD
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City | SKANEATELES
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State | NY
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Zip | 13152-9379
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Country | US
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Telephone | 315-426-6838
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Fax | 315-426-6801
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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 | 1835P1300X
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Taxonomy Name | Psychiatric Pharmacist
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License Number | 044555
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License Number State | NY
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