Individual
HEBERT RYAN ABBOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
103 GREAT OAKS BLVD, ALBANY, NY 12203
(518) 464-1091
(518) 464-0445
Mailing address
103 GREAT OAKS BLVD, ALBANY, NY 12203
(518) 464-1091
(518) 464-0445
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
135736
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00627674
—
NY
01
—
10000287
CDPHP
NY
01
—
26401
MVP
—
01
—
7819685
AETNA
—
Enumeration date
02/06/2007
Last updated
07/08/2007
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