Provider Demographics
NPI:1801867767
Name:FOLEY, DENNIS K (PA)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:K
Last Name:FOLEY
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:100 SIMSBURY RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-3793
Mailing Address - Country:US
Mailing Address - Phone:860-284-5111
Mailing Address - Fax:860-284-5114
Practice Address - Street 1:100 SIMSBURY RD
Practice Address - Street 2:SUITE 203
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-3793
Practice Address - Country:US
Practice Address - Phone:860-284-5111
Practice Address - Fax:860-284-5114
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2010-05-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT000317363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1801867767OtherNPI
970023645Medicare PIN
P48353Medicare UPIN
CT1801867767OtherNPI