Healthcare Provider Details

I. General information

NPI: 1538166921
Provider Name (Legal Business Name): ELIZABETH A FOLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2005
Last Update Date: 12/05/2011
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 SUITE 670
WORCESTER MA
01608
US

V. Phone/Fax

Practice location:
  • Phone: 781-251-0029
  • Fax: 781-251-0229
Mailing address:
  • Phone: 508-754-3566
  • Fax: 508-438-6368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number72659
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number72659
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: