Provider Demographics
NPI:1861698565
Name:ABDALLAH, ANTHONY Y (DC)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:Y
Last Name:ABDALLAH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 OUTWATER LN
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-2619
Mailing Address - Country:US
Mailing Address - Phone:973-827-3544
Mailing Address - Fax:973-827-3588
Practice Address - Street 1:259 OUTWATER LN
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-2619
Practice Address - Country:US
Practice Address - Phone:973-827-3544
Practice Address - Fax:973-827-3588
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00645000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor