Provider Demographics
NPI:1386194041
Name:ABELLANA, JOSEPH A (MS, RN, AGACNP-BC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:A
Last Name:ABELLANA
Suffix:
Gender:M
Credentials:MS, RN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W 165TH ST APT 5I
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-7915
Mailing Address - Country:US
Mailing Address - Phone:347-931-7166
Mailing Address - Fax:
Practice Address - Street 1:600 W 165TH ST APT 5I
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-7915
Practice Address - Country:US
Practice Address - Phone:347-931-7166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF431044-1363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care