Provider Demographics
NPI:1114657665
Name:ABINGTON HEALTH GROUP, LLC
Entity Type:Organization
Organization Name:ABINGTON HEALTH GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLISON ANN
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:LYAVDANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:AGNP-C, PMHNP-BC
Authorized Official - Phone:570-331-8372
Mailing Address - Street 1:1143 NORTHERN BLVD # 101
Mailing Address - Street 2:
Mailing Address - City:SOUTH ABINGTON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18411-2221
Mailing Address - Country:US
Mailing Address - Phone:570-331-8273
Mailing Address - Fax:
Practice Address - Street 1:611 CARNATION DR
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-2111
Practice Address - Country:US
Practice Address - Phone:570-331-8273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-15
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty