Provider Demographics
NPI:1043273345
Name:FOSTER, JANELLE M (OD)
Entity type:Individual
Prefix:DR
First Name:JANELLE
Middle Name:M
Last Name:FOSTER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4815 LIBERTY AVE
Mailing Address - Street 2:M-25
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2156
Mailing Address - Country:US
Mailing Address - Phone:412-621-7038
Mailing Address - Fax:412-578-1166
Practice Address - Street 1:4815 LIBERTY AVE
Practice Address - Street 2:M-25
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-621-7038
Practice Address - Fax:412-578-1166
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001506152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011223600001Medicaid
PA080846Medicare PIN
PAV00416Medicare UPIN