Provider Demographics
NPI:1376694471
Name:HERRON, ABIGAIL JANE (DO)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:JANE
Last Name:HERRON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2006 MADISON AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-1217
Mailing Address - Country:US
Mailing Address - Phone:347-201-0541
Mailing Address - Fax:855-685-5320
Practice Address - Street 1:2006 MADISON AVE FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-1217
Practice Address - Country:US
Practice Address - Phone:347-201-0541
Practice Address - Fax:855-685-5320
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2422482084P0800X, 2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry