Provider Demographics
NPI:1699827253
Name:FOSTER, RENEE T (DC)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:T
Last Name:FOSTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:T
Other - Last Name:FARRAYY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:207 WEST UNION AVENUE
Mailing Address - Street 2:FLOOR 1
Mailing Address - City:BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08805
Mailing Address - Country:US
Mailing Address - Phone:732-537-0009
Mailing Address - Fax:732-537-9966
Practice Address - Street 1:207 WEST UNION AVENUE
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805
Practice Address - Country:US
Practice Address - Phone:732-537-0009
Practice Address - Fax:732-537-9966
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00562000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ056377Medicare ID - Type Unspecified
U89532Medicare UPIN