Provider Demographics
NPI:1740059229
Name:ABAKADA
Entity type:Organization
Organization Name:ABAKADA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPO
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:917-435-1789
Mailing Address - Street 1:5917 69TH PL FL 2
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-2926
Mailing Address - Country:US
Mailing Address - Phone:917-435-1789
Mailing Address - Fax:
Practice Address - Street 1:5917 69TH PL FL 2
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-2926
Practice Address - Country:US
Practice Address - Phone:917-435-1789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-26
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management