Provider Demographics
NPI:1255516050
Name:PATRICK ABIUSO MD PC
Entity type:Organization
Organization Name:PATRICK ABIUSO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ACCOUNT REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-572-0809
Mailing Address - Street 1:1900 FRONTAGE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2211
Mailing Address - Country:US
Mailing Address - Phone:856-429-1910
Mailing Address - Fax:856-429-1912
Practice Address - Street 1:1900 FRONTAGE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2211
Practice Address - Country:US
Practice Address - Phone:856-429-1910
Practice Address - Fax:856-429-1912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA31840207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty