Provider Demographics
NPI:1942743752
Name:ABBEY, MICHAEL DAVIS (APN)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:DAVIS
Last Name:ABBEY
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 MAIN ST STE 210
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-7149
Mailing Address - Country:US
Mailing Address - Phone:201-210-8859
Mailing Address - Fax:201-882-6327
Practice Address - Street 1:131 MAIN ST STE 210
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-7149
Practice Address - Country:US
Practice Address - Phone:201-210-8859
Practice Address - Fax:201-882-6327
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-28
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00679200363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology