Provider Demographics
NPI:1730438094
Name:ABOLEY, NADIA
Entity type:Individual
Prefix:DR
First Name:NADIA
Middle Name:
Last Name:ABOLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13979 85TH DR APT 5D
Mailing Address - Street 2:
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435-2741
Mailing Address - Country:US
Mailing Address - Phone:718-208-6450
Mailing Address - Fax:
Practice Address - Street 1:4591 SOUTHWESTERN BLVD APT R8
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NY
Practice Address - Zip Code:14075-1982
Practice Address - Country:US
Practice Address - Phone:718-308-6450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-02
Last Update Date:2012-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY57128183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist