Provider Demographics
NPI:1346336948
Name:ABATEMARCO, AUDREY ANN (DPM)
Entity Type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:ANN
Last Name:ABATEMARCO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:40 MONROE ST FI3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-7726
Mailing Address - Country:US
Mailing Address - Phone:212-962-3919
Mailing Address - Fax:212-227-0523
Practice Address - Street 1:20 MONROE ST LF1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-7605
Practice Address - Country:US
Practice Address - Phone:212-962-3919
Practice Address - Fax:212-227-0523
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003693213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00877409Medicaid
NY10210444OtherAMERIGROUP
NY134527655 0005OtherCIGNA
NY100096978201OtherAMERICHOICE UNITED HEALTH CARE
NY1315314OtherCOVENTRY HEALTHCARE
NY50079OtherGHI EMBLEMHEALTH PPO
NY1314314OtherFIRST HEALTH
NY0050079OtherGHI
NY050127000029OtherFIDELIS CARE
NYP515833OtherOXFORD MEDICARE COMPLETE
NY1346336948OtherAARP MEDICARE COMPLETE SECURE HORIZONS
NY4510217OtherAETNA
NYP515833OtherOXFORD
NYPG 7301OtherBC/BS
NYP515833OtherOXFORD
NYPG 7301OtherBC/BS
NYP515833OtherOXFORD MEDICARE COMPLETE
NY4510217OtherAETNA