=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861224065
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANCIS ABANILLA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/15/2024
-----------------------------------------------------
Last Update Date | 08/15/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 461 PARK AVE S FL 11
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-7568
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-696-2727
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3 HUNTINGTON QUADRANGLE STE 103N
-----------------------------------------------------
City | MELVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11747-4601
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-474-2816
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 052608
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------