Healthcare Provider Details

I. General information

NPI: 1306839402
Provider Name (Legal Business Name): ABIGAIL A NEIGHMOND D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 MEDICAL PARK DR
BALLSTON SPA NY
12020-5050
US

IV. Provider business mailing address

PO BOX 3810
JOPLIN MO
64803-3810
US

V. Phone/Fax

Practice location:
  • Phone: 518-289-2775
  • Fax:
Mailing address:
  • Phone: 417-347-2540
  • Fax: 417-347-2539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number303268
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: