Provider Demographics
NPI:1669879813
Name:ANIAGYEI, ABIGAIL
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:ANIAGYEI
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ABIGAIL
Other - Middle Name:AFUA
Other - Last Name:ANIAGYEI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:1 EVES DRIVE
Mailing Address - Street 2:SUITE 111 OFFICE 134
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08503
Mailing Address - Country:US
Mailing Address - Phone:800-897-9177
Mailing Address - Fax:866-616-0686
Practice Address - Street 1:1 EVES DR STE 111134
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3125
Practice Address - Country:US
Practice Address - Phone:800-897-9177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-02
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00531100363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology