Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 2027861-1 | NY |
N | 207N00000X | Dermatologist | MA61267 | NJ |
Y | 207ND0101X | MOHS-Micrographic Surgeon | MA61267 | NJ |
N | 207ND0900X | Dermatopathologist | 202786-1 | NY |
N | 207ND0900X | Dermatopathologist | MA61267 | NJ |
N | 207NP0225X | Pediatric Dermatologist | 202786-1 | NY |
N | 207NP0225X | Pediatric Dermatologist | MA61267 | NJ |
N | 207NS0135X | Procedural Dermatology | 202786-1 | NY |
N | 207NS0135X | Procedural Dermatology | MA61267 | NJ |
NPI | 1558347229 |
---|---|
Provider Name | Carter Grant Abel |
First Address | Annandale, NJ 08801-3129 |
Second Address | Annandale, NJ 08801-3129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2005 |
Last Update Date | 14/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F40827 | (02) |