Provider Demographics
NPI:1518068493
Name:ABEMAYOR, VIOLET J (MD)
Entity Type:Individual
Prefix:
First Name:VIOLET
Middle Name:J
Last Name:ABEMAYOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 LAKEVILLE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042
Mailing Address - Country:US
Mailing Address - Phone:516-488-9700
Mailing Address - Fax:516-488-8826
Practice Address - Street 1:410 LAKEVILLE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042
Practice Address - Country:US
Practice Address - Phone:516-488-9700
Practice Address - Fax:516-488-8826
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153176207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1518068493Medicaid
NY1518068493Medicaid
NYE56353Medicare UPIN