Provider Demographics
NPI:1295816601
Name:FOLEY, JAMES JOSEPH (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOSEPH
Last Name:FOLEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 JACKSON STREET
Mailing Address - Street 2:
Mailing Address - City:PORT CARBON
Mailing Address - State:PA
Mailing Address - Zip Code:17965-1522
Mailing Address - Country:US
Mailing Address - Phone:570-622-9417
Mailing Address - Fax:570-622-9417
Practice Address - Street 1:500 TERRY RICH BLVD
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR
Practice Address - State:PA
Practice Address - Zip Code:17970-1090
Practice Address - Country:US
Practice Address - Phone:570-429-2650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000718152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015201210005Medicaid