Provider Demographics
NPI:1245035641
Name:FOSTER, BRYNN (RDN, LDN)
Entity type:Individual
Prefix:
First Name:BRYNN
Middle Name:
Last Name:FOSTER
Suffix:
Gender:
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 WASHINGTON RD STE 211
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-2534
Mailing Address - Country:US
Mailing Address - Phone:412-746-7613
Mailing Address - Fax:
Practice Address - Street 1:4150 WASHINGTON RD STE 211
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-2534
Practice Address - Country:US
Practice Address - Phone:412-746-7613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN008782133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered