Provider Demographics
NPI:1598790982
Name:FOSTER, SUSAN ELIZABETH (MS PT)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 ELWYN RD
Mailing Address - Street 2:KIVITZ BLDG PHYS REHAB
Mailing Address - City:ELWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19063-4622
Mailing Address - Country:US
Mailing Address - Phone:610-891-2656
Mailing Address - Fax:610-891-2280
Practice Address - Street 1:111 ELWYN RD
Practice Address - Street 2:KIVITZ BLDG PHYS REHAB
Practice Address - City:ELWYN
Practice Address - State:PA
Practice Address - Zip Code:19063-4622
Practice Address - Country:US
Practice Address - Phone:610-891-2656
Practice Address - Fax:610-891-2280
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012468L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01858976 01OtherAMERICHOICE
PA1154160OtherKEYSTONE MERCY
PA2091653000OtherIBC HMO OUT OF NETWORK
PA2670221OtherUSHEALTHCARE
PA2670221OtherAETNA
PA0018589760001Medicaid
PA18625PT012468LOtherHEALTH PARTNERS