Provider Demographics
NPI:1750630927
Name:ABBONDANZA, JANET THERESA (RN)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:THERESA
Last Name:ABBONDANZA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:THERESA
Other - Last Name:MASI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2037 LOUIS KOSSUTH AVE.
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-6318
Mailing Address - Country:US
Mailing Address - Phone:631-585-4734
Mailing Address - Fax:
Practice Address - Street 1:2037 LOUIS KOSSUTH AVE.
Practice Address - Street 2:
Practice Address - City:RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-6318
Practice Address - Country:US
Practice Address - Phone:631-585-4734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-04
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY380739-1163W00000X, 163WC2100X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC2100XNursing Service ProvidersRegistered NurseContinence Care
No163WS0200XNursing Service ProvidersRegistered NurseSchool