Healthcare Provider Details

I. General information

NPI: 1831599976
Provider Name (Legal Business Name): KRISTINA ABANES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2014
Last Update Date: 09/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

452 OLD HOOK RD
EMERSON NJ
07630-1381
US

IV. Provider business mailing address

223 N VAN DIEN AVE
RIDGEWOOD NJ
07450-2726
US

V. Phone/Fax

Practice location:
  • Phone: 201-666-3900
  • Fax: 201-261-0505
Mailing address:
  • Phone: 201-447-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00497700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: