Provider Demographics
NPI:1740582097
Name:FOSTER, DAWN VIVIAN (RN)
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:VIVIAN
Last Name:FOSTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 E 182ND ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-1838
Mailing Address - Country:US
Mailing Address - Phone:929-228-4512
Mailing Address - Fax:
Practice Address - Street 1:1057 WESTCHESTER AVE
Practice Address - Street 2:URBAN HEALTH PLAN
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-4852
Practice Address - Country:US
Practice Address - Phone:718-589-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-18
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY460107-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse