Provider Demographics
NPI:1164429122
Name:ABELES, JAY S (DPM)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:S
Last Name:ABELES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4136 HICKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-6216
Mailing Address - Country:US
Mailing Address - Phone:516-796-2900
Mailing Address - Fax:516-796-2901
Practice Address - Street 1:4136 HICKSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-6216
Practice Address - Country:US
Practice Address - Phone:516-796-2900
Practice Address - Fax:516-796-2901
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-06
Last Update Date:2013-11-07
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-04-06
Provider Licenses
StateLicense IDTaxonomies
NYN004665-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist