MEDICARE: ALBERT E ABBOTT JR. MD

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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	27545	SC

General Provider Information

NPI Number	:	1881666311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALBERT E ABBOTT JR. MD

Provider Business Mailing Address
First Line	:	214 CORNELIA ST
Second Line	:	SUITE 201
City	:	PLATTSBURGH
State	:	NY
Zip	:	12901-2306
Country	:	US
Telephone Number	:	518-562-7993
Fax Number	:	518-562-7064

Provider Business Practice Location Address
First Line	:	214 CORNELIA ST
Second Line	:	SUITE 201
City	:	PLATTSBURGH
State	:	NY
Zip	:	12901-2306
Country	:	US
Telephone Number	:	518-562-7993
Fax Number	:	518-562-7064

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

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	04/26/2010

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