Provider Demographics
NPI:1497795413
Name:FOSTER, PAUL N (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:N
Last Name:FOSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 BEECH RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-3722
Mailing Address - Country:US
Mailing Address - Phone:443-632-8421
Mailing Address - Fax:
Practice Address - Street 1:25 ROCKWOOD PL FL 1
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4937
Practice Address - Country:US
Practice Address - Phone:201-568-3335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD55942207R00000X
MDD0055942207R00000X
NJ25MA10939700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDKJ15GB/60686901OtherCAREFIRST OF MD GBMC
MD619800700Medicaid
MDS1380005OtherCAREFIRST REGIONAL GBMC
MD110212202Medicare PIN
MD725L98HHMedicare PIN
MD619800700Medicaid
MD712L/188753YBPGMedicare PIN