Provider Demographics
NPI:1275608341
Name:ABED, ANTOINE TONY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTOINE TONY
Middle Name:
Last Name:ABED
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 1:374 W 125TH ST
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-4820
Mailing Address - Country:US
Mailing Address - Phone:212-749-7960
Mailing Address - Fax:212-663-7235
Practice Address - Street 1:374 W 125TH ST
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4820
Practice Address - Country:US
Practice Address - Phone:212-749-7960
Practice Address - Fax:212-663-7235
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY182478207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01242075Medicaid
NYW11891Medicare ID - Type Unspecified
NY01242075Medicaid