Pauline Marie Abolnar, ANP FNP NURSE PRACTI

Key facts

NPI

1417023151

Entity type

Individual (NPI type 1)

Primary specialty

Registered Nurse 163W00000X

License

RN414664 (NY)

Practice address

189 Wheatly Rd
Brookville, NY 11545

Phone

(516) 686-4400

Fax

(516) 686-4425

NPI assigned

Nov 27, 2006

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 11, 2025.

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1417023151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 AMBROSE LANE",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "11768",
            "telephone_number": "631-261-0258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 WHEATLY RD",
            "city": "BROOKVILLE",
            "state": "NY",
            "postal_code": "11545",
            "telephone_number": "516-686-4400",
            "fax_number": "516-686-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOLNAR",
        "first_name": "PAULINE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "ANP FNP NURSE PRACTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "RN414664",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "301806ANP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "FNP332903",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00305592",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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