Provider Demographics
NPI:1851466429
Name:FOGLIA, SALVATORE SAM SR (MD)
Entity Type:Individual
Prefix:MR
First Name:SALVATORE
Middle Name:SAM
Last Name:FOGLIA
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:312 WEST HILLS ROAD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION LI
Mailing Address - State:NY
Mailing Address - Zip Code:11746-3616
Mailing Address - Country:US
Mailing Address - Phone:631-423-1808
Mailing Address - Fax:631-421-2303
Practice Address - Street 1:312 WEST HILLS ROAD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION LI
Practice Address - State:NY
Practice Address - Zip Code:11746-3616
Practice Address - Country:US
Practice Address - Phone:631-421-2300
Practice Address - Fax:631-421-2303
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103993207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
103993OtherLIC
839941Medicare ID - Type Unspecified
C12152Medicare UPIN