Provider Demographics
NPI:1972842169
Name:ADDEI, ABIGAIL K (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:K
Last Name:ADDEI
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1543 INWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-2001
Mailing Address - Country:US
Mailing Address - Phone:855-681-8700
Mailing Address - Fax:
Practice Address - Street 1:1543-1545 INWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-2001
Practice Address - Country:US
Practice Address - Phone:855-681-8700
Practice Address - Fax:718-294-4765
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342367363LF0000X
NY663234163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse