Provider Demographics
NPI:1134182710
Name:SIEGEL, ABBY L (MD)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:L
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 FAWN LN
Mailing Address - Street 2:
Mailing Address - City:ARMONK
Mailing Address - State:NY
Mailing Address - Zip Code:10504-1126
Mailing Address - Country:US
Mailing Address - Phone:914-219-5427
Mailing Address - Fax:
Practice Address - Street 1:1011 HIGH RIDGE RD
Practice Address - Street 2:#207
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-1610
Practice Address - Country:US
Practice Address - Phone:914-219-5427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0053723208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics