Provider Demographics
NPI:1093808966
Name:ABADI, JULES S (MD)
Entity Type:Individual
Prefix:
First Name:JULES
Middle Name:S
Last Name:ABADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 SILLS RD
Mailing Address - Street 2:BLDG 5-6 SUITE A
Mailing Address - City:EAST PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772
Mailing Address - Country:US
Mailing Address - Phone:631-475-9300
Mailing Address - Fax:631-475-6648
Practice Address - Street 1:285 SILLS RD
Practice Address - Street 2:BLDG 5-6 SUITE A
Practice Address - City:EAST PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772
Practice Address - Country:US
Practice Address - Phone:631-475-9300
Practice Address - Fax:631-475-6648
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182724207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
02L542Medicare ID - Type Unspecified
F40949Medicare UPIN