Basic Information
| Provider Information | |||||||||
| NPI: | 1023033800 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TOUSSAINT-FOSTER | ||||||||
| FirstName: | YARDLIE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | TOUSSAINT | ||||||||
| OtherFirstName: | YARDLIE | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 22581 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100872581 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104824795 | ||||||||
| FaxNumber: | 8565283117 | ||||||||
| Practice Location | |||||||||
| Address1: | 1590 MEDICAL DR STE A | ||||||||
| Address2: | |||||||||
| City: | POTTSTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194643247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103267172 | ||||||||
| FaxNumber: | 6103260974 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2006 | ||||||||
| LastUpdateDate: | 06/28/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 06/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 232696 | NY | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | OS013749 | PA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 1017009460001 | 05 | NY | MEDICAID | 1878720 | 01 | NY | BCBS | OTHER | 2739751000 | 01 | NY | BCBS | OTHER | 204634462 | 01 | NY | AMERIHEALTH MERCY | OTHER | 30035062 | 01 | NY | KEYSTONE MERCY | OTHER | 7820561 | 01 | NY | AETNA | OTHER | 1017009460002 | 05 | NY | MEDICAID | 10170094601 | 01 | NY | AMERICHOICE | OTHER | 1416213 | 01 | NY | AETNA HMO | OTHER | 2706729000 | 01 | NY | BCBS | OTHER |