MEDICARE: AIMEE ABANTE PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	041281	NY

General Provider Information

NPI Number	:	1497293948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIMEE ABANTE PT

Provider Business Mailing Address
First Line	:	4050 NOSTRAND AVE
Second Line	:	M2
City	:	BROOKLYN
State	:	NY
Zip	:	11235-2234
Country	:	US
Telephone Number	:	718-676-7933
Fax Number	:	718-676-7935

Provider Business Practice Location Address
First Line	:	4050 NOSTRAND AVE
Second Line	:	4050 NOSTRAND AVE
City	:	BROOKLYN
State	:	NY
Zip	:	11235-2234
Country	:	US
Telephone Number	:	718-676-7933
Fax Number	:	718-676-7935

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2017
Last Update Date	:	02/04/2017

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