MEDICARE: RICHARD JOSEPH FOLEY P.T

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	05663	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	806698	OTHER	NY	MANAGE PHYSIACL NETWORK

General Provider Information

NPI Number	:	1598897589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD JOSEPH FOLEY P.T

Provider Business Mailing Address
First Line	:	4175 VETERANS MEMORIAL HWY
Second Line	:	SUITE 202
City	:	RONKONKOMA
State	:	NY
Zip	:	11779-7639
Country	:	US
Telephone Number	:	631-580-5200
Fax Number	:	631-580-5222

Provider Business Practice Location Address
First Line	:	3535 HILL BLVD
Second Line	:	SUITE P
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-1293
Country	:	US
Telephone Number	:	914-962-2728
Fax Number	:	914-962-1729

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	10/17/2016

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