Provider Demographics
NPI:1447557228
Name:FOSTER, STEFANIE LYNN (MS)
Entity Type:Individual
Prefix:MS
First Name:STEFANIE
Middle Name:LYNN
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3133 MILBURN AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-4844
Mailing Address - Country:US
Mailing Address - Phone:203-641-6783
Mailing Address - Fax:
Practice Address - Street 1:9730 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3245
Practice Address - Country:US
Practice Address - Phone:718-896-7726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool