Healthcare Provider Details

I. General information

NPI: 1477116119
Provider Name (Legal Business Name): MELISSA RUTH ABBUHL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2019
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 SCHOOLHOUSE RD
ALBANY NY
12203-3834
US

IV. Provider business mailing address

28 PINE HOLLOW RD
SLINGERLANDS NY
12159-9654
US

V. Phone/Fax

Practice location:
  • Phone: 518-456-1211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number320207
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: