Provider Demographics
NPI:1861489585
Name:ABAY, ABERA H (MD)
Entity Type:Individual
Prefix:
First Name:ABERA
Middle Name:H
Last Name:ABAY
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 1:79 WAWECUS ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2160
Mailing Address - Country:US
Mailing Address - Phone:860-886-2655
Mailing Address - Fax:
Practice Address - Street 1:79 WAWECUS ST
Practice Address - Street 2:SUITE 101
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2160
Practice Address - Country:US
Practice Address - Phone:860-886-2655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT039924207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
7734330OtherAETNA PPO
2858099OtherAETNA HMO
CT770220OtherCONNECTICARE
CTP2671380OtherOXFORD HEALTH PLAN
CT010039924CT02OtherANTHEM BCBS OF CT
CT770220OtherCONNECTICARE
CTP2671380OtherOXFORD HEALTH PLAN
H57344Medicare UPIN