Provider Demographics
NPI:1366694416
Name:ABELLO-POBLETE, MARIA VERONICA R (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:VERONICA R
Last Name:ABELLO-POBLETE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIA VERONICA
Other - Middle Name:ROMAN
Other - Last Name:ABELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1601 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:COMBS FARM
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3836
Mailing Address - Country:US
Mailing Address - Phone:609-371-0669
Mailing Address - Fax:609-584-9227
Practice Address - Street 1:1601 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619-3836
Practice Address - Country:US
Practice Address - Phone:609-838-9040
Practice Address - Fax:609-838-9042
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08785500207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0240478Medicaid
NJ0240478Medicaid