Provider Demographics
NPI:1700521952
Name:HRUSOVSKY, ABIGAIL T (PA-C)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:T
Last Name:HRUSOVSKY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:T
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1717 WEST MAIN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055
Mailing Address - Country:US
Mailing Address - Phone:220-564-2900
Mailing Address - Fax:220-564-2901
Practice Address - Street 1:1717 WEST MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055
Practice Address - Country:US
Practice Address - Phone:220-564-2900
Practice Address - Fax:220-564-2901
Is Sole Proprietor?:No
Enumeration Date:2022-05-02
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant