Provider Demographics
NPI:1497796023
Name:ABELLANA, JUAN C (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:C
Last Name:ABELLANA
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 1:3626 ROUTE 1 N
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-5922
Mailing Address - Country:US
Mailing Address - Phone:609-243-0445
Mailing Address - Fax:609-452-7577
Practice Address - Street 1:11 CENTRE DR
Practice Address - Street 2:SUITE A
Practice Address - City:MONROE TWP
Practice Address - State:NJ
Practice Address - Zip Code:08831-1564
Practice Address - Country:US
Practice Address - Phone:609-395-2470
Practice Address - Fax:609-860-5288
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02707200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1174002Medicaid
NJC58690Medicare UPIN
NJ1174002Medicaid