Provider Demographics
NPI:1245089895
Name:BRIDGEWATER, ABIGAIL (PHLEBOTOMIST)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:
Last Name:BRIDGEWATER
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:BRIDGEWATER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 DAIRY ST
Mailing Address - Street 2:
Mailing Address - City:FORT PLAIN
Mailing Address - State:NY
Mailing Address - Zip Code:13339-1304
Mailing Address - Country:US
Mailing Address - Phone:518-844-2799
Mailing Address - Fax:
Practice Address - Street 1:1 DAIRY ST
Practice Address - Street 2:
Practice Address - City:FORT PLAIN
Practice Address - State:NY
Practice Address - Zip Code:13339-1304
Practice Address - Country:US
Practice Address - Phone:518-844-2799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYZ2M2F8F3246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy