Provider Demographics
NPI:1245966126
Name:ABIONA, VINCENT A (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:A
Last Name:ABIONA
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 KNIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-4200
Mailing Address - Country:US
Mailing Address - Phone:215-612-4000
Mailing Address - Fax:
Practice Address - Street 1:10800 KNIGHTS RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-4200
Practice Address - Country:US
Practice Address - Phone:215-612-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-25
Last Update Date:2023-07-10
Deactivation Date:2023-06-06
Deactivation Code:
Reactivation Date:2023-07-10
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAMT228904390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program