Provider Demographics
NPI:1164700613
Name:FOELSTER, MARK ANDREW (PA-C, PT)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:ANDREW
Last Name:FOELSTER
Suffix:
Gender:M
Credentials:PA-C, PT
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Other - First Name:
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Mailing Address - Street 1:280 CHESTNUT STREET
Mailing Address - Street 2:2ND FL
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1001
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:95 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2306
Practice Address - Country:US
Practice Address - Phone:413-542-2267
Practice Address - Fax:413-542-2647
Is Sole Proprietor?:No
Enumeration Date:2011-08-02
Last Update Date:2023-04-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA19241225100000X
MAPA5527363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist