Provider Demographics
NPI:1386197465
Name:MINA ABADEER DPM PC
Entity Type:Organization
Organization Name:MINA ABADEER DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABADEER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:973-837-8173
Mailing Address - Street 1:277 INDIAN TRL
Mailing Address - Street 2:
Mailing Address - City:MOUNTAINSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07092-1818
Mailing Address - Country:US
Mailing Address - Phone:201-919-1343
Mailing Address - Fax:201-603-1812
Practice Address - Street 1:211 ESSEX ST STE 405
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-3247
Practice Address - Country:US
Practice Address - Phone:201-919-1343
Practice Address - Fax:201-603-1812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-26
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00332500213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty