Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 204460 | NY |
NPI | 1154364156 |
---|---|
Provider Name | David Foster |
First Address | Rochester, NY 14642-0001 |
Second Address | Rochester, NY 14623-4284 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 26/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01690468 | (05) | NY |
P00869653 | MEDICARE RAILROAD (01) | NY |