1881773737 NPI number — DR. OANA OLIVIA ABIDI M.D.

Table of content: DR. OANA OLIVIA ABIDI M.D. (NPI 1881773737)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881773737 NPI number — DR. OANA OLIVIA ABIDI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ABIDI
Provider First Name:
OANA
Provider Middle Name:
OLIVIA
Provider Name Prefix Text:
DR.
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:
TALLE(MAIDEN)ANTOHI-FORMER MARRIAGE
Provider Other First Name:
OANA
Provider Other Middle Name:
OLIVIA
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1881773737
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 JAEGGER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLEN HEAD
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11545-1825
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-671-0109
Provider Business Mailing Address Fax Number:
516-671-0126

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 GARDEN CITY PLZ
Provider Second Line Business Practice Location Address:
SUITE 324
Provider Business Practice Location Address City Name:
GARDEN CITY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11530-3302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-294-9036
Provider Business Practice Location Address Fax Number:
516-294-9087
Provider Enumeration Date:
11/03/2006

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: 2084P0800X , with the licence number:  205768 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2084P0804X , with the licence number: 205768 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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





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