Provider Demographics
NPI:1396890174
Name:BUDNICK, ABBY ILENE (DC)
Entity type:Individual
Prefix:DR
First Name:ABBY
Middle Name:ILENE
Last Name:BUDNICK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-4530
Mailing Address - Country:US
Mailing Address - Phone:516-565-0200
Mailing Address - Fax:516-565-0202
Practice Address - Street 1:800 PRESTON RD
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-4530
Practice Address - Country:US
Practice Address - Phone:516-565-0200
Practice Address - Fax:516-565-0202
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005679-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX34711Medicare ID - Type Unspecified