Individual
MS. ABIGAIL FUQUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2822 ASTORIA BLVD # 2D, ASTORIA, NY 11102-1932
(617) 312-6354
Mailing address
2822 ASTORIA BLVD # 2D, ASTORIA, NY 11102-1932
(617) 312-6354
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86110312
NY
Other
Enumeration date
01/04/2022
Last updated
01/04/2022
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