Provider Demographics
NPI:1326300898
Name:FOSTER, SUSAN EILEEN (OTR)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:EILEEN
Last Name:FOSTER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:EILEEN
Other - Last Name:MCCONNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:633 ROUTE 28
Mailing Address - Street 2:
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869-1127
Mailing Address - Country:US
Mailing Address - Phone:908-872-0215
Mailing Address - Fax:
Practice Address - Street 1:633 ROUTE 28
Practice Address - Street 2:
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869-1127
Practice Address - Country:US
Practice Address - Phone:908-872-0215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00483600225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology