Provider Demographics
NPI:1225340920
Name:ABBEY MEDICAL ASSOCIATES PC
Entity Type:Organization
Organization Name:ABBEY MEDICAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ABBEY
Authorized Official - Last Name:ACHINDIBA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:401-954-2831
Mailing Address - Street 1:173 LOCUST GLEN DR
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02921-1035
Mailing Address - Country:US
Mailing Address - Phone:401-954-2831
Mailing Address - Fax:
Practice Address - Street 1:139 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6352
Practice Address - Country:US
Practice Address - Phone:401-954-2831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA242643261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
RII43395Medicare UPIN