Provider Demographics
NPI:1609527555
Name:SPECHT, ABIGAIL M
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:M
Last Name:SPECHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-2308
Mailing Address - Country:US
Mailing Address - Phone:716-675-9232
Mailing Address - Fax:716-675-9217
Practice Address - Street 1:70 LINWOOD AVE
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-2308
Practice Address - Country:US
Practice Address - Phone:716-675-9232
Practice Address - Fax:716-675-9217
Is Sole Proprietor?:No
Enumeration Date:2022-01-12
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF403942-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health