Provider Demographics
NPI:1871924670
Name:ETTINGER, ABIGAIL (DO)
Entity type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:
Last Name:ETTINGER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 ROUTE 28 STE 2205
Mailing Address - Street 2:
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869-1363
Mailing Address - Country:US
Mailing Address - Phone:908-725-5530
Mailing Address - Fax:
Practice Address - Street 1:575 ROUTE 28 STE 2100
Practice Address - Street 2:
Practice Address - City:RARITAN
Practice Address - State:NJ
Practice Address - Zip Code:08869-1363
Practice Address - Country:US
Practice Address - Phone:908-725-5530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-03
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB10212600208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty