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General NPI Number Information
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NPI Number | 1841574563
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Entity Type | Individual
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Provider Name | ABIGAIL RYAN GLEASON LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/29/2011
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 719 HARRISON ST
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City | SYRACUSE
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State | NY
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Zip | 13210-2695
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Country | US
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Telephone | 315-464-3265
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Fax |
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Provider Business Mailing Address
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Address Line | 689 N CLINTON ST APT 301
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City | SYRACUSE
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State | NY
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Zip | 13204-1487
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Country | US
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Telephone | 315-406-3886
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 098920
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License Number State | NY
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