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General NPI Number Information
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NPI Number | 1962834077
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Entity Type | Organization
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Legal Business Name | BRIAN ABALUCK, LLC
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Dates
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Enumeration Date | 07/31/2013
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Last Update Date | 05/23/2014
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Provider Practice Location Address
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Address Line | 2 INDUSTRIAL BLVD STE 100
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City | PAOLI
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State | PA
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Zip | 19301-1645
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Country | US
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Telephone | 484-565-1358
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Fax | 484-565-1312
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Provider Business Mailing Address
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Address Line | 2 INDUSTRIAL BLVD STE 100
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City | PAOLI
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State | PA
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Zip | 19301-1645
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Country | US
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Telephone | 484-565-1358
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Fax | 484-565-1312
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Authorized Official
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Title or Position | CEO
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Name | BRIAN K ABALUCK
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Credential | MD
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Telephone | 484-565-1358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number | MD4455233
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD4455233
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License Number State | PA
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