Provider Demographics
NPI:1265982813
Name:FOSTER, JUSTIN I
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:
Last Name:FOSTER
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 MARLBOROUGH AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-3315
Mailing Address - Country:US
Mailing Address - Phone:908-546-0573
Mailing Address - Fax:
Practice Address - Street 1:1424 MARLBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-3315
Practice Address - Country:US
Practice Address - Phone:908-546-0573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer