Provider Demographics
NPI:1912216821
Name:ABERNATHY, ANGELA PATRICE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:PATRICE
Last Name:ABERNATHY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E 60TH ST STE 1101
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1139
Mailing Address - Country:US
Mailing Address - Phone:212-262-2952
Mailing Address - Fax:212-355-2888
Practice Address - Street 1:30 E 60TH ST STE 1101
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1139
Practice Address - Country:US
Practice Address - Phone:212-262-2952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0551921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice