Provider Demographics
NPI:1942399332
Name:ABERDALE, DEBRA (NP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:ABERDALE
Suffix:
Gender:F
Credentials:NP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SOUTHWOODS BLVD 4TH FLOOR
Mailing Address - Street 2:CAPITAL CARDIOLOGY ASSOCIATES, PC
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12211-2526
Mailing Address - Country:US
Mailing Address - Phone:518-292-6000
Mailing Address - Fax:518-292-6050
Practice Address - Street 1:2231 BURDETT AVENUE #160
Practice Address - Street 2:CAPITAL CARDIOLOGY ASSOCIATES, PC
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180
Practice Address - Country:US
Practice Address - Phone:518-292-6200
Practice Address - Fax:518-292-6050
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF331140363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110122037AMedicaid
VT1029925Medicaid
NY02340747Medicaid
VT1029925Medicaid