Provider Demographics
NPI:1295881191
Name:ABODEELY, NANCY (PT)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:
Last Name:ABODEELY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 DIVISADERO ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3043
Mailing Address - Country:US
Mailing Address - Phone:415-833-4680
Mailing Address - Fax:415-833-2612
Practice Address - Street 1:1635 DIVISADERO ST STE 300
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3043
Practice Address - Country:US
Practice Address - Phone:415-833-4680
Practice Address - Fax:415-833-2612
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA017999225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist