Hebert Ryan Abbott, MD
Individual provider Active NPI Pediatric Adolescent Medicine Physician · Albany, NY
NPI 1932248697 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1932248697
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Adolescent Medicine Physician 2080A0000X
- License
- 135736 (NY)
- Practice address
- 103 Great Oaks Blvd
Albany, NY 12203 - Phone
- (518) 464-1091
- Fax
- (518) 464-0445
- NPI assigned
- Feb 6, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 135736 | NY | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albany Medical College | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 135736 | NY | Yes |
Addresses
Primary practice location
103 Great Oaks Blvd
Albany, NY 12203
Mailing address
103 Great Oaks Blvd
Albany, NY 12203
Phone (518) 464-1091
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26401 | Other | MVP | |
| 10000287 | Other | NY | CDPHP |
| 7819685 | Other | AETNA | |
| 00627674 | Medicaid | NY |
Other providers in Albany, NY
- Rachel Abate
- Adam Hesham Abbas
- Lynn M Abbate
- David Abbenda
- Katharine Anne Abbot
- Frederick Bryant Abbuhl
- Jake Abbuhl
- Melissa Ruth Abbuhl
- Hassan Mohamed Abdalla
- Nakia C Abdelmeged
All providers in Albany, NY · Pediatric Adolescent Medicine Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.