Provider Demographics
NPI:1871770255
Name:ALLEN, ABIGAIL KINCAID (MD)
Entity type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:KINCAID
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:KINCAID
Other - Last Name:LYNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5 E 98TH ST.
Mailing Address - Street 2:BOX 1188
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-241-9561
Mailing Address - Fax:212-534-6202
Practice Address - Street 1:5 E 98TH ST.
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-9561
Practice Address - Fax:212-534-6202
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000898207X00000X
NY253018207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000898OtherTEMPORARY STATE LICENSE
CAA104354OtherCA STATE LICENSE