Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 4394 | MA |
NPI | 1003867102 |
---|---|
Provider Name | Dr. Matthew D Foley |
First Address | Amesbury, MA 01913-4315 |
Second Address | Amesbury, MA 01913-4128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2006 |
Last Update Date | 10/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0703150 | (05) | MA |
3076401 | (05) | NH |
U95952 | (02) |