Provider Demographics
NPI:1891053690
Name:BETH ABATE NURSE PRACTITIONER LLC
Entity Type:Organization
Organization Name:BETH ABATE NURSE PRACTITIONER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:BETELEHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ABATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-447-9995
Mailing Address - Street 1:6910 MAYFAIR RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5237
Mailing Address - Country:US
Mailing Address - Phone:240-447-9995
Mailing Address - Fax:301-776-0087
Practice Address - Street 1:6910 MAYFAIR RD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5237
Practice Address - Country:US
Practice Address - Phone:240-447-9995
Practice Address - Fax:301-776-0087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-30
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty