Provider Demographics
NPI:1730273418
Name:ABENANTE, FRANK ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:ANDREW
Last Name:ABENANTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:LONGPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08403
Mailing Address - Country:US
Mailing Address - Phone:609-823-3304
Mailing Address - Fax:609-597-5657
Practice Address - Street 1:588 EAST BAY AVE.
Practice Address - Street 2:SUITE 4
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050
Practice Address - Country:US
Practice Address - Phone:609-597-5656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA064824002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7050909Medicaid
NJ890739Medicare ID - Type Unspecified
NJ7050909Medicaid