Provider Demographics
NPI:1982393732
Name:MAHALINGAM, ABINI (PA)
Entity Type:Individual
Prefix:
First Name:ABINI
Middle Name:
Last Name:MAHALINGAM
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ABINI
Other - Middle Name:
Other - Last Name:MAHALINGAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:1 CAMPUS RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-4479
Mailing Address - Country:US
Mailing Address - Phone:719-390-3100
Mailing Address - Fax:
Practice Address - Street 1:1 CAMPUS RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-4479
Practice Address - Country:US
Practice Address - Phone:718-390-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant