Provider Demographics
NPI:1881083079
Name:ABAGAT, ERRIN NOVERO
Entity type:Individual
Prefix:
First Name:ERRIN
Middle Name:NOVERO
Last Name:ABAGAT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10550 PARK RUN DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89144-4575
Mailing Address - Country:US
Mailing Address - Phone:702-515-6200
Mailing Address - Fax:702-413-7731
Practice Address - Street 1:10550 PARK RUN DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89144-4575
Practice Address - Country:US
Practice Address - Phone:702-515-6200
Practice Address - Fax:702-413-7731
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-1037225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant