Provider Demographics
NPI:1568511921
Name:ABBATE, GREGG A (OD)
Entity Type:Individual
Prefix:DR
First Name:GREGG
Middle Name:A
Last Name:ABBATE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 AUTUMN CT
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-5314
Mailing Address - Country:US
Mailing Address - Phone:856-637-2475
Mailing Address - Fax:
Practice Address - Street 1:2010 MARLTON PIKE W
Practice Address - Street 2:STE C
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2776
Practice Address - Country:US
Practice Address - Phone:856-663-9494
Practice Address - Fax:856-662-5451
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00594400152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist