Provider Demographics
NPI:1235314352
Name:ABBATIELLO, GERALDINE A (PHD, GNP, PMHNP)
Entity type:Individual
Prefix:DR
First Name:GERALDINE
Middle Name:A
Last Name:ABBATIELLO
Suffix:
Gender:F
Credentials:PHD, GNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 SHERIDAN DR
Mailing Address - Street 2:
Mailing Address - City:PAWLING
Mailing Address - State:NY
Mailing Address - Zip Code:12564-1031
Mailing Address - Country:US
Mailing Address - Phone:845-855-1508
Mailing Address - Fax:
Practice Address - Street 1:1 S GREELEY AVE
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514-3346
Practice Address - Country:US
Practice Address - Phone:914-238-0045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340153363LG0600X
NY40 400749363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology