Provider Demographics
NPI:1962425942
Name:ABESSINIO, PHILIP DP (DC)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:DP
Last Name:ABESSINIO
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 1:25020 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-2149
Mailing Address - Country:US
Mailing Address - Phone:718-343-0474
Mailing Address - Fax:718-962-2818
Practice Address - Street 1:25020 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-2149
Practice Address - Country:US
Practice Address - Phone:718-343-0474
Practice Address - Fax:718-962-2818
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX0035711111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T31786Medicare UPIN
NY17733Medicare ID - Type Unspecified