Provider Demographics
NPI:1336157635
Name:ABELLANA, VICTORIA D (MD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:D
Last Name:ABELLANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3626 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-5922
Mailing Address - Country:US
Mailing Address - Phone:609-243-0445
Mailing Address - Fax:609-452-7577
Practice Address - Street 1:300 ETRA RD.
Practice Address - Street 2:MEADOW LAKES CLINIC-
Practice Address - City:HIGHTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08520
Practice Address - Country:US
Practice Address - Phone:609-426-6815
Practice Address - Fax:609-426-6871
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02711400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE69032Medicare UPIN