Healthcare Provider Details

I. General information

NPI: 1457675084
Provider Name (Legal Business Name): T RAYMOND FOLEY IV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2010
Last Update Date: 05/17/2022
Certification Date: 05/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 HARRISBURG AVE
LANCASTER PA
17603-2964
US

IV. Provider business mailing address

217 HARRISBURG AVE
LANCASTER PA
17603-2964
US

V. Phone/Fax

Practice location:
  • Phone: 717-544-8300
  • Fax: 717-544-8265
Mailing address:
  • Phone: 717-544-8300
  • Fax: 717-544-8265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberA146563
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number76692
License Number StateMT
# 4
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD472086
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: