Provider Demographics
NPI:1558391201
Name:CAAMPUED, ABRAHAM IBANEZ (MD)
Entity Type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:IBANEZ
Last Name:CAAMPUED
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 1:1 NORTON AVE
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-2629
Mailing Address - Country:US
Mailing Address - Phone:607-432-4024
Mailing Address - Fax:
Practice Address - Street 1:1 NORTON AVE
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-2629
Practice Address - Country:US
Practice Address - Phone:607-432-4024
Practice Address - Fax:607-432-4773
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY164980207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00961977Medicaid
NYB82798Medicare UPIN
NY00961977Medicaid