Healthcare Provider Details

I. General information

NPI: 1053247833
Provider Name (Legal Business Name): EILEEN FOLEY LANG DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 SWAN ST
BEVERLY MA
01915-3119
US

IV. Provider business mailing address

2 FOSTERS PT
BEVERLY MA
01915-3912
US

V. Phone/Fax

Practice location:
  • Phone: 703-402-6412
  • Fax:
Mailing address:
  • Phone: 978-578-3020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL4659
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: