Provider Demographics
NPI:1134185432
Name:ABED, MARY T (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:T
Last Name:ABED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:120 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-2326
Mailing Address - Country:US
Mailing Address - Phone:201-216-9791
Mailing Address - Fax:201-216-1362
Practice Address - Street 1:120 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07307-2326
Practice Address - Country:US
Practice Address - Phone:201-216-9791
Practice Address - Fax:201-216-1362
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA05677600207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5036305Medicaid
NJ681620Medicare PIN
NJ5036305Medicaid
NJ060063086Medicare PIN