Provider Demographics
NPI:1871238022
Name:KABIA, ELLA-MARIE MAMEISIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLA-MARIE
Middle Name:MAMEISIA
Last Name:KABIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 W WALNUT ST APT 207
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18101-2269
Mailing Address - Country:US
Mailing Address - Phone:609-498-1471
Mailing Address - Fax:
Practice Address - Street 1:1648 S 4TH ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-4922
Practice Address - Country:US
Practice Address - Phone:610-674-4550
Practice Address - Fax:610-674-4554
Is Sole Proprietor?:No
Enumeration Date:2022-05-02
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT225861207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine