Provider Demographics
NPI:1437144359
Name:ABIS, MICHELLE J (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:J
Last Name:ABIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1528
Mailing Address - Country:US
Mailing Address - Phone:845-876-2051
Mailing Address - Fax:845-876-2052
Practice Address - Street 1:18 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1528
Practice Address - Country:US
Practice Address - Phone:845-876-2051
Practice Address - Fax:845-876-2052
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213360207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01924381Medicaid
NYG06856Medicare UPIN
NY48C051Medicare PIN
NY48C05NW001Medicare PIN
NY01924381Medicaid