Provider Demographics
NPI:1376879627
Name:ABBOTT, ANNABELLA (OT)
Entity Type:Individual
Prefix:MS
First Name:ANNABELLA
Middle Name:
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 CROTON AVE
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-4430
Mailing Address - Country:US
Mailing Address - Phone:914-944-2700
Mailing Address - Fax:914-944-8170
Practice Address - Street 1:162 CROTON AVE
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-4430
Practice Address - Country:US
Practice Address - Phone:914-944-2700
Practice Address - Fax:914-944-8170
Is Sole Proprietor?:No
Enumeration Date:2009-10-21
Last Update Date:2010-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY066204-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0288462SMedicaid