Basic Information
| Provider Information | |||||||||
| NPI: | 1538166921 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FOLEY | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 340 MAIN ST | ||||||||
| Address2: | SUITE 670 | ||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5087543566 | ||||||||
| FaxNumber: | 5084386368 | ||||||||
| Practice Location | |||||||||
| Address1: | 333 ELM ST | ||||||||
| Address2: | STE. 205 | ||||||||
| City: | DEDHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020264530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7812510029 | ||||||||
| FaxNumber: | 7812510229 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2005 | ||||||||
| LastUpdateDate: | 12/05/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 202K00000X | 72659 | MA | Y | Allopathic & Osteopathic Physicians | Phlebology | 207V00000X | 72659 | MA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 13725 | 01 | HARVARD PILGRIM POS | OTHER | 0016762 | 01 | NEIGHBORHOOD HEALTH PLAN | OTHER | 8186449 | 01 | HEALTHSOURCE MASS. | OTHER | J11407 | 01 | BS- BLUE CARE ELECT | OTHER | J11407 | 01 | HMO BLUE/BLUE CHOICE | OTHER | 072659 | 01 | TUFTS COMMONWEALTH PPO | OTHER | 8186449 | 01 | CIGNA HEALTH CARE | OTHER | J11407 | 01 | BLUE SHIELD-INDEMNITY | OTHER | 07-00753 | 01 | UNITED HEALTHCARE HMO PPO | OTHER | 13725 | 01 | HARVARD/PILGRIM | OTHER | E93037 | 01 | FIRST SENIORITY | OTHER | 072659 | 01 | TUFTS | OTHER | 072659 | 01 | TUFTS BENEFIT ADMIN. | OTHER | 072659 | 01 | TUFTS TOTAL HEALTH PLAN | OTHER | 13725 | 01 | HARVARD PILGRIM PPO | OTHER | 16003690 | 01 | RAILROAD/MEDICARE | OTHER | 27397 | 01 | CHILDREN'S MEDICAL SEC. | OTHER |