Provider Demographics
NPI:1134872294
Name:HEALEY, ABIGAIL (PHARMD)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:HEALEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 BROADWAY APT A
Mailing Address - Street 2:
Mailing Address - City:FORT EDWARD
Mailing Address - State:NY
Mailing Address - Zip Code:12828-1960
Mailing Address - Country:US
Mailing Address - Phone:518-338-7230
Mailing Address - Fax:
Practice Address - Street 1:2160 STATE ROUTE 9
Practice Address - Street 2:
Practice Address - City:LAKE GEORGE
Practice Address - State:NY
Practice Address - Zip Code:12845-6120
Practice Address - Country:US
Practice Address - Phone:518-668-0043
Practice Address - Fax:518-668-0051
Is Sole Proprietor?:No
Enumeration Date:2022-01-30
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI068742183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist