Healthcare Provider Details

I. General information

NPI: 1235330283
Provider Name (Legal Business Name): CORI MICHELLE ABIKOFF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 01/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 SKYLINE DRIVE DEPARTMENT OF HEMATOLOGY ONCOLOGY NYMC
VALHALLA NY
10595
US

IV. Provider business mailing address

25 ROCKLEDGE AVE APT 1109
WHITE PLAINS NY
10601-1214
US

V. Phone/Fax

Practice location:
  • Phone: 914-594-2130
  • Fax:
Mailing address:
  • Phone: 412-780-8352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMT188834
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD60150963
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number272097
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: