Provider Demographics
NPI:1346576717
Name:DE ANGELIS, ABBY ALEXANDRA (PT)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:ALEXANDRA
Last Name:DE ANGELIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:ALEXANDRA
Other - Last Name:KARPINSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1377 MOTOR PKWY
Mailing Address - Street 2:STE 307
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-5249
Mailing Address - Country:US
Mailing Address - Phone:631-580-5200
Mailing Address - Fax:631-580-5222
Practice Address - Street 1:15 NEWARK AVE
Practice Address - Street 2:STE A
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-1123
Practice Address - Country:US
Practice Address - Phone:973-759-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-20
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031737225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist