Healthcare Provider Details

I. General information

NPI: 1366420101
Provider Name (Legal Business Name): VEIN AND AESTHETIC CENTER OF BOSTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 ELM ST STE. 205
DEDHAM MA
02026-4530
US

IV. Provider business mailing address

340 MAIN ST STE. 670
WORCESTER MA
01608-1604
US

V. Phone/Fax

Practice location:
  • Phone: 781-251-0029
  • Fax: 781-251-0229
Mailing address:
  • Phone: 508-754-3566
  • Fax: 508-798-8012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateMA

VIII. Authorized Official

Name: DR. ELIZABETH A FOLEY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 781-251-0029