Provider Demographics
NPI:1013154459
Name:FOSTER, SANDRA GEEHRENG (MAC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:GEEHRENG
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 TALMAGE LN
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11937-2264
Mailing Address - Country:US
Mailing Address - Phone:631-267-9500
Mailing Address - Fax:
Practice Address - Street 1:524 MONTAUK HIGHWAY
Practice Address - Street 2:
Practice Address - City:AMAGANSETT
Practice Address - State:NY
Practice Address - Zip Code:11930
Practice Address - Country:US
Practice Address - Phone:631-267-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003967-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist