Provider Demographics
NPI:1942904222
Name:HABTEZGHI, ABIEL BERHE (MD)
Entity Type:Individual
Prefix:DR
First Name:ABIEL
Middle Name:BERHE
Last Name:HABTEZGHI
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 1:504 S LANSDOWNE AVE., LANSDOWNE STATION APARTMENTS
Mailing Address - Street 2:G-02
Mailing Address - City:YEADON
Mailing Address - State:PA
Mailing Address - Zip Code:19050-2436
Mailing Address - Country:US
Mailing Address - Phone:215-294-7461
Mailing Address - Fax:
Practice Address - Street 1:1500 LANSDOWNE AVE., MERCY FITZGERALD HOSPITAL
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-1200
Practice Address - Country:US
Practice Address - Phone:610-237-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-11-06
Deactivation Date:2023-11-01
Deactivation Code:
Reactivation Date:2023-11-06
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program