MEDICARE: JENNIFER ABITABILO APN-C

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	363LF0000X	Family Nurse Practitioner	26NJ00443700	NJ

General Provider Information

NPI Number	:	1528400074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ABITABILO APN-C

Provider Business Mailing Address
First Line	:	65 TERRACE AVE
Second Line	:	APT 1
City	:	HASBROUCK HEIGHTS
State	:	NJ
Zip	:	07604-2428
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	65 TERRACE AVE
Second Line	:	APT 1
City	:	HASBROUCK HEIGHTS
State	:	NJ
Zip	:	07604-2428
Country	:	US
Telephone Number	:	609-462-7213
Fax Number	:

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

Provider Enumeration Date	:	07/25/2013
Last Update Date	:	07/25/2013

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