Individual
JEREMY FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4338 WETZEL RD, LIVERPOOL, NY 13090-2011
(315) 453-1500
(315) 453-1134
Mailing address
PO BOX 74, SOUTH OTSELIC, NY 13155-0074
(315) 571-5128
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
545399
NY
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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