Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 217255 | MA |
N | 207Q00000X | Family Doctor | 217255 | MA |
NPI | 1598740227 |
---|---|
Provider Name | William Foley |
First Address | Newton, MA 02466-1316 |
Second Address | Newton, MA 02466-1316 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2005 |
Last Update Date | 10/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I36442 | (02) | MA |