Provider Demographics
NPI:1376750075
Name:ABEDOR, CAROLYN (PT)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:
Last Name:ABEDOR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1235
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:NY
Mailing Address - Zip Code:12498-8235
Mailing Address - Country:US
Mailing Address - Phone:845-679-9767
Mailing Address - Fax:
Practice Address - Street 1:2568 ROUTE 212
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:NY
Practice Address - Zip Code:12498-2132
Practice Address - Country:US
Practice Address - Phone:845-679-9767
Practice Address - Fax:845-679-9767
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013119-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist