Provider Demographics
NPI:1902187222
Name:OBERRITER, ABBY RUTH O'DONNELL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ABBY
Middle Name:RUTH O'DONNELL
Last Name:OBERRITER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ABBY
Other - Middle Name:RUTH
Other - Last Name:O'DONNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:44 OXFORD RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-2660
Mailing Address - Country:US
Mailing Address - Phone:315-223-8889
Mailing Address - Fax:315-223-8890
Practice Address - Street 1:44 OXFORD RD
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-2660
Practice Address - Country:US
Practice Address - Phone:315-223-8889
Practice Address - Fax:315-223-8890
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019266103TB0200X, 103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Provider Identifiers
StateIdentifier IDID TypeIssuer
J400058711Medicare PIN