Provider Demographics
NPI:1235355280
Name:ABASKHROUN, MARY ANN
Entity Type:Individual
Prefix:
First Name:MARY ANN
Middle Name:
Last Name:ABASKHROUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 S ROUTE 9W # 55
Mailing Address - Street 2:
Mailing Address - City:WEST HAVERSTRAW
Mailing Address - State:NY
Mailing Address - Zip Code:10993-1055
Mailing Address - Country:US
Mailing Address - Phone:845-786-4000
Mailing Address - Fax:
Practice Address - Street 1:51- 55 NORTH ROUTE 9W
Practice Address - Street 2:
Practice Address - City:WEST HAVERSTRAW
Practice Address - State:NY
Practice Address - Zip Code:10993-1055
Practice Address - Country:US
Practice Address - Phone:845-786-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028803-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist