Provider Demographics
NPI:1346807195
Name:FOSTER, NICOLE CHERISE (DC)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:CHERISE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:NINA
Other - Middle Name:
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:26 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2771
Mailing Address - Country:US
Mailing Address - Phone:862-205-4847
Mailing Address - Fax:973-201-1192
Practice Address - Street 1:26 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2771
Practice Address - Country:US
Practice Address - Phone:862-205-4847
Practice Address - Fax:973-201-1192
Is Sole Proprietor?:No
Enumeration Date:2019-05-28
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33777111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor