Individual
ANGELA Y ABBOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
31 HYDE LN, CORAM, NY 11727-3524
(631) 830-7915
Mailing address
PO BOX 802, CORAM, NY 11727-0802
(631) 830-7915
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
262689
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02886060
—
NY
Enumeration date
09/20/2007
Last updated
09/20/2007
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