Healthcare Provider Details

I. General information

NPI: 1992238570
Provider Name (Legal Business Name): GEORGE FOULARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 WILLIAM ST RM 303
NEW YORK NY
10038-5307
US

IV. Provider business mailing address

156 WILLIAM ST RM 303
NEW YORK NY
10038-5307
US

V. Phone/Fax

Practice location:
  • Phone: 718-866-4435
  • Fax: 844-749-3064
Mailing address:
  • Phone: 718-866-4435
  • Fax: 844-749-3064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License NumberV9769
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number25MA11905300
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number320084
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: