Provider Demographics
NPI:1831309004
Name:THE DOCTOR'S ABARY MD PA
Entity Type:Organization
Organization Name:THE DOCTOR'S ABARY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:V
Authorized Official - Last Name:ABARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-585-1213
Mailing Address - Street 1:445 WHITE HORSE AVE
Mailing Address - Street 2:SUITE 20
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-1408
Mailing Address - Country:US
Mailing Address - Phone:609-585-1213
Mailing Address - Fax:609-585-0309
Practice Address - Street 1:445 WHITE HORSE AVE
Practice Address - Street 2:SUITE 20
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-1408
Practice Address - Country:US
Practice Address - Phone:609-585-1213
Practice Address - Fax:609-585-0309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA31160207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ078028Medicare PIN