Healthcare Provider Details

I. General information

NPI: 1518466838
Provider Name (Legal Business Name): ABIGAIL MORRISSEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2018
Last Update Date: 02/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

726 BROADWAY
NEW YORK NY
10003-9616
US

IV. Provider business mailing address

726 BROADWAY
NEW YORK NY
10003-9616
US

V. Phone/Fax

Practice location:
  • Phone: 212-443-1120
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number684400-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: