Provider Demographics
NPI:1043642002
Name:JAMULA, ABIGAIL E (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:E
Last Name:JAMULA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:E
Other - Last Name:HAFENSTEINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8 ANSELM TER
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3106
Mailing Address - Country:US
Mailing Address - Phone:617-926-2300
Mailing Address - Fax:617-923-5886
Practice Address - Street 1:1 BRAINTREE ST ST
Practice Address - Street 2:
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-1956
Practice Address - Country:US
Practice Address - Phone:617-787-8700
Practice Address - Fax:617-787-8106
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-01
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist