Basic Information
Provider Information
NPI: 1881298875
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOLEY
FirstName: MEGAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 40 GENERAL MILLER RD
Address2:  
City: PETERBOROUGH
State: NH
PostalCode: 034581215
CountryCode: US
TelephoneNumber: 6037166647
FaxNumber:  
Practice Location
Address1: 239 PLEASANT ST
Address2:  
City: CONCORD
State: NH
PostalCode: 033017504
CountryCode: US
TelephoneNumber: 6032246561
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/30/2020
LastUpdateDate: 11/30/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/30/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
224Z00000X  Y Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant 

No ID Information.


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