Healthcare Provider Details

I. General information

NPI: 1508747262
Provider Name (Legal Business Name): ABIGAIL LYNN MENDYGRAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 DAVIS ST
SCRANTON PA
18505-2927
US

IV. Provider business mailing address

86 W LIBERTY ST
HANOVER TOWNSHIP PA
18706-1725
US

V. Phone/Fax

Practice location:
  • Phone: 570-341-3794
  • Fax:
Mailing address:
  • Phone: 570-332-5940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRP459715
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP459715
License Number StatePA

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: