Provider Demographics
NPI:1174957005
Name:BARDEN, ABIGAIL N (PT, DPT)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:N
Last Name:BARDEN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:N
Other - Last Name:GUYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:771 PILOT HOUSE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-1990
Mailing Address - Country:US
Mailing Address - Phone:757-873-2302
Mailing Address - Fax:757-873-2306
Practice Address - Street 1:3510 ANDERSON HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139-5846
Practice Address - Country:US
Practice Address - Phone:804-598-2100
Practice Address - Fax:804-598-7624
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305208283225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC05954OtherMEDICARE GROUP PTAN
VA1174957005OtherMEDICAID QMB
VAC05954OtherMEDICARE GROUP PTAN