MEDICARE: ABIGAIL ELIZABETH SHEILDS PA

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	363A00000X	Physician Assistant	25MP00967200	NJ

General Provider Information

NPI Number	:	1700766680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL ELIZABETH SHEILDS PA

Provider Business Mailing Address
First Line	:	1 FEDERAL ST STE 200
Second Line	:
City	:	CAMDEN
State	:	NJ
Zip	:	08103-1088
Country	:	US
Telephone Number	:	848-288-6935
Fax Number	:

Provider Business Practice Location Address
First Line	:	4011 ROUTE 9 S STE 201
Second Line	:
City	:	RIO GRANDE
State	:	NJ
Zip	:	08242-1918
Country	:	US
Telephone Number	:	609-770-7788
Fax Number	:

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

Provider Enumeration Date	:	09/03/2025
Last Update Date	:	02/05/2026

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