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General NPI Number Information
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NPI Number | 1043767163
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Entity Type | Individual
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Provider Name | JEFFREY PETER ABELL PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/07/2016
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Last Update Date | 12/23/2021
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Provider Practice Location Address
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Address Line | 82 CATAMOUNT PARK
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City | MIDDLEBURY
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State | VT
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Zip | 05753
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Country | US
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Telephone | 802-388-6777
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Fax |
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Provider Business Mailing Address
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Address Line | 74 PLEASANT ST STE 204
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City | NEW LONDON
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State | NH
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Zip | 03257-5881
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Country | US
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Telephone | 603-526-4635
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Fax | 603-526-8283
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 055.0031315
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 055-0031315
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License Number State | VT
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