Provider Demographics
NPI:1497846224
Name:LEGASPI, ABBELANE S (MD)
Entity Type:Individual
Prefix:
First Name:ABBELANE
Middle Name:S
Last Name:LEGASPI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 SULLIVAN WAY
Mailing Address - Street 2:
Mailing Address - City:WEST TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-3406
Mailing Address - Country:US
Mailing Address - Phone:609-633-1562
Mailing Address - Fax:609-633-8527
Practice Address - Street 1:301 SULLIVAN WAY
Practice Address - Street 2:
Practice Address - City:WEST TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08628-3406
Practice Address - Country:US
Practice Address - Phone:609-633-1562
Practice Address - Fax:609-633-8527
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0427322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF24031Medicare UPIN
NJME716999Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER