Provider Demographics
NPI:1316988637
Name:ABPLANALP, DOUGLAS EDWARD (PT, ATC)
Entity type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:EDWARD
Last Name:ABPLANALP
Suffix:
Gender:M
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 BENTON HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:NY
Mailing Address - Zip Code:12754-2401
Mailing Address - Country:US
Mailing Address - Phone:845-594-7588
Mailing Address - Fax:
Practice Address - Street 1:62 BENTON HOLLOW RD
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:NY
Practice Address - Zip Code:12754-2401
Practice Address - Country:US
Practice Address - Phone:845-594-7588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027019-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ20B71Medicare ID - Type Unspecified