Provider Demographics
NPI:1942606835
Name:STANLEY J FOSTER III MD PC
Entity Type:Organization
Organization Name:STANLEY J FOSTER III MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:203-577-6550
Mailing Address - Street 1:1625 STRAITS TPKE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-1836
Mailing Address - Country:US
Mailing Address - Phone:203-577-6550
Mailing Address - Fax:203-577-6551
Practice Address - Street 1:1625 STRAITS TPKE
Practice Address - Street 2:SUITE 108
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-1836
Practice Address - Country:US
Practice Address - Phone:203-577-6550
Practice Address - Fax:203-577-6551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT034457208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty