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General NPI Number Information
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NPI Number | 1780332536
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Entity Type | Individual
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Provider Name | EVAN ABPLANALP PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 03/11/2022
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Last Update Date | 03/11/2022
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Provider Practice Location Address
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Address Line | 1000 LEGACY AT PARK CRESCENT
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City | GREECE
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State | NY
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Zip | 14616
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Country | US
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Telephone | 814-221-8133
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Fax |
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Provider Business Mailing Address
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Address Line | 15 OWANA WAY APT 5
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City | LAKEWOOD
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State | NY
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Zip | 14750-1109
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Country | US
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Telephone | 814-221-8133
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 040316
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License Number State | NY
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