Provider Demographics
NPI:1326136003
Name:FOLEY, THOMAS BERNARD (MOTRL)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:BERNARD
Last Name:FOLEY
Suffix:
Gender:M
Credentials:MOTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 36204
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87176
Mailing Address - Country:US
Mailing Address - Phone:505-550-0557
Mailing Address - Fax:505-299-6558
Practice Address - Street 1:1641 CATRON AVE SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-4255
Practice Address - Country:US
Practice Address - Phone:505-550-0557
Practice Address - Fax:505-299-6558
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1531225XH1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHuman Factors
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000A0199Medicaid