Provider Demographics
NPI:1407740038
Name:ABBY J WELLNESS PLLC
Entity type:Organization
Organization Name:ABBY J WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:ABULINE
Authorized Official - Middle Name:PATIENCE
Authorized Official - Last Name:JAIDAH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:857-245-5583
Mailing Address - Street 1:145 TREMONT ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1208
Mailing Address - Country:US
Mailing Address - Phone:857-245-5583
Mailing Address - Fax:
Practice Address - Street 1:145 TREMONT ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1208
Practice Address - Country:US
Practice Address - Phone:857-245-5583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty