Healthcare Provider Details

I. General information

NPI: 1336481191
Provider Name (Legal Business Name): ABIGAIL KAMENS ENGEL P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 11/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL RD 2D
LEOMINSTER MA
01453-2253
US

IV. Provider business mailing address

100 HOSPITAL RD 2D
LEOMINSTER MA
01453-2253
US

V. Phone/Fax

Practice location:
  • Phone: 978-534-0582
  • Fax: 978-534-6519
Mailing address:
  • Phone: 978-534-0582
  • Fax: 978-534-6519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA4652
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: