Provider Demographics
NPI:1518929009
Name:HERNANDEZ ABREU, ANDRES RAMON (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:RAMON
Last Name:HERNANDEZ ABREU
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 1:563 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-3502
Mailing Address - Country:US
Mailing Address - Phone:718-302-1170
Mailing Address - Fax:718-302-1109
Practice Address - Street 1:563 GRAND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-3502
Practice Address - Country:US
Practice Address - Phone:718-302-1170
Practice Address - Fax:718-302-1109
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174938207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01082911Medicaid
NY01082911Medicaid
NYA61610Medicare UPIN