Provider Demographics
NPI:1033321088
Name:MCNALL, ABIGAIL ROSE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:ROSE
Last Name:MCNALL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:DODGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:200 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 370
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501
Mailing Address - Country:US
Mailing Address - Phone:516-663-4525
Mailing Address - Fax:516-663-4532
Practice Address - Street 1:200 OLD COUNTRY RD
Practice Address - Street 2:SUITE 370
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4235
Practice Address - Country:US
Practice Address - Phone:516-663-4525
Practice Address - Fax:516-663-4532
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF-333337-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily