Provider Demographics
NPI:1801832720
Name:ABEAR, IMELDA R (MD)
Entity Type:Individual
Prefix:DR
First Name:IMELDA
Middle Name:R
Last Name:ABEAR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3 LYON PL
Mailing Address - Street 2:SUITE 307
Mailing Address - City:OGDENSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:13669-2590
Mailing Address - Country:US
Mailing Address - Phone:315-393-0340
Mailing Address - Fax:315-393-0710
Practice Address - Street 1:3 LYON PL
Practice Address - Street 2:SUITE 307
Practice Address - City:OGDENSBURG
Practice Address - State:NY
Practice Address - Zip Code:13669-2590
Practice Address - Country:US
Practice Address - Phone:315-393-0340
Practice Address - Fax:315-393-0710
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY207949208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01496744Medicaid