Healthcare Provider Details

I. General information

NPI: 1669291068
Provider Name (Legal Business Name): ABIGAIL ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2024
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 MAIN ST
MANCHESTER CT
06040-4128
US

IV. Provider business mailing address

84 WINTER ST
STRATFORD CT
06614-4740
US

V. Phone/Fax

Practice location:
  • Phone: 860-643-1607
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number17634
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: