1447222625 NPI number — GWEN D ABELES M.D.

Table of content: GWEN D ABELES M.D. (NPI 1447222625)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447222625 NPI number — GWEN D ABELES M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ABELES
Provider First Name:
GWEN
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447222625
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SADDLE RIVER
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07458-0002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-307-0075
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
221 W GRAND AVE STE 102B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONTVALE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07645-1729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-307-0075
Provider Business Practice Location Address Fax Number:
201-307-5072
Provider Enumeration Date:
02/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207NS0135X , with the licence number:  066287 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1800172 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 11466 . This is a "HUDSON HEALTHPLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 08U071 . This is a "EMPIRE BLUECROSS BLUESHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000042299 . This is a "GHI HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1C7736 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8872440 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2299921 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 103201 . This is a "WELLCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P946339 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02040655 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 070013873 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5663484 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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