Provider Demographics
NPI:1043243926
Name:ABPLANALP, MARY ROSE (NP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ROSE
Last Name:ABPLANALP
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:20 GRAND ST FL 3
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1035
Mailing Address - Country:US
Mailing Address - Phone:845-323-2942
Mailing Address - Fax:845-368-5962
Practice Address - Street 1:255 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4812
Practice Address - Country:US
Practice Address - Phone:845-323-2942
Practice Address - Fax:845-368-5962
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2020-11-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF332229363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02213014Medicaid