Healthcare Provider Details

I. General information

NPI: 1831362078
Provider Name (Legal Business Name): TERESA FOLEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERESA MARY KATERI O'HERRON MD

II. Dates (important events)

Enumeration Date: 04/09/2008
Last Update Date: 09/09/2022
Certification Date: 09/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 CAMPBELL AVE
WEST HAVEN CT
06516-2770
US

IV. Provider business mailing address

47 ACORN RD
BRANFORD CT
06405-6142
US

V. Phone/Fax

Practice location:
  • Phone: 203-932-5711
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number58030
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number57133
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number57133
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: