Provider Demographics
NPI:1841282829
Name:KREISER, FOSTER E JR (OD)
Entity type:Individual
Prefix:DR
First Name:FOSTER
Middle Name:E
Last Name:KREISER
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 CENTURY DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-4375
Mailing Address - Country:US
Mailing Address - Phone:717-697-1414
Mailing Address - Fax:717-697-4921
Practice Address - Street 1:890 CENTURY DR
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-4375
Practice Address - Country:US
Practice Address - Phone:717-697-1414
Practice Address - Fax:717-697-4921
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000137152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232175708OtherOTHER
PACF0050OtherMEDICARE RAILROAD
PA558206OtherBLUE SHIELD
PA392326OtherNVA
PA78848OtherAETNA HMO
PA7990388OtherGATEWAY
PA990388OtherKEYSTONE HMO
PA5798509OtherAETNA PPO
PA01979601OtherCAPITAL BLUE CROSS
PAU08993Medicare UPIN
PACF0050OtherMEDICARE RAILROAD
PA5798509OtherAETNA PPO